Selective Serotonin Reuptake Inhibitor (SSRI) updated on 07-01-2025

Ectopic pregnancy

R analysis
id Study   Lib. in paper Exposition period    Study type 
 Control type 
 
Tags OR 95%CI x1/n1 x0/n0 no cases no exposed ROB Ref.
S13259
R51069		 Wall-Wieler, 2020 Ectopic pregnancy early pregnancy retrospective cohort (claims database) unexposed, sick Adjustment: Yes Monotherapy: no or not specified Unexposed sick: intermediate history of illness/treatment (3-12 months before pregnancy) 0.99 [0.90;1.08] 608/28,434   1,681/78,354 2,289 28,434
ref
S493
R15259		 Colvin, 2011 Ectopic pregnancy 1st trimester retrospective cohort (claims database) unexposed (general population or NOS) Adjustment: No Monotherapy: no or not specified 1.05 [0.73;1.42] 44/3,565   1,483/119,840 1,527 3,565
ref
S5958
R15303		 Diav-Citrin - Fluoxetine or Paroxetine, 2008 Ectopic pregnancy during pregnancy (anytime or not specified) excluded prospective cohort unexposed (general population or NOS) Adjustment: No Monotherapy: no or not specified 1.81 [0.11;29.05] C
excluded (exposition period) 		1/809   1/1,467 2 809
ref
S508
R17590		 Sivojelezova - Citalopram, 2005 Ectopic pregnancy during pregnancy (anytime or not specified) excluded prospective cohort unexposed (general population or NOS) Adjustment: No Matched Monotherapy: no or not specified 1.00 [0.02;50.78] C
excluded (exposition period) 		0/132   0/132 0 132
ref
S490
R15189		 Chambers - Fluoxetine, 1996 Ectopic pregnancy 1st trimester prospective cohort unexposed (general population or NOS) Adjustment: No Monotherapy: no or not specified 4.99 [0.20;123.20] C 1/154   0/254 1 154
ref
Total 3 studies 1.00 [0.91;1.09] 3,817 32,153
x1: number of endpoints among exposed, n1: number of exposed; x0: number of endpoints among non exposed, n0: number of non exposed; C: calculated odds ratio from numbers of events and effectives

Forest plot

StudyTE95% CIn casesn exposedweightROBABCDEF Wall-Wieler, 2020Wall-Wieler, 2020 0.99[0.90; 1.08]2,28928,43493%ROB confusion: moderateROB selection: lowROB classification: criticalROB missing: unclearROB mesure: moderateROB reporting: moderate Colvin, 2011Colvin, 2011 1.05[0.73; 1.42]1,5273,5657%ROB confusion: criticalROB selection: lowROB classification: criticalROB missing: unclearROB mesure: moderateROB reporting: moderate Chambers - Fluoxetine, 1996Chambers - Fluoxetine, 1996 4.99[0.20; 123.20]11540%ROB confusion: criticalROB selection: criticalROB classification: lowROB missing: lowROB mesure: moderateROB reporting: moderate Total (3 studies) I2 = 0% 1.00[0.91; 1.09]3,81732,1530.210.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.00[0.91; 1.09]3,81732,1530%NAWall-Wieler, 2020 Colvin, 2011 Chambers - Fluoxetine, 1996 3 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.07[0.77; 1.49]1,5283,7190%NAColvin, 2011 Chambers - Fluoxetine, 1996 2 unexposed, sickunexposed, sick 0.99[0.90; 1.08]2,28928,434 -NAWall-Wieler, 2020 1 Tags Adjustment   - No  - No 1.07[0.77; 1.49]1,5283,7190%NAColvin, 2011 Chambers - Fluoxetine, 1996 2   - Yes  - Yes 0.99[0.90; 1.08]2,28928,434 -NAWall-Wieler, 2020 1 Monotherapy   - no or not specified  - no or not specified 1.00[0.91; 1.09]3,81732,1530%NAWall-Wieler, 2020 Colvin, 2011 Chambers - Fluoxetine, 1996 3 Unexposed sick   - intermediate history of illness/tre ...  - intermediate history of illness/treatment (3-12 months before pregnancy) 0.99[0.90; 1.08]2,28928,434 -NAWall-Wieler, 2020 1 All studiesAll studies 1.00[0.91; 1.09]3,81732,1530%NAWall-Wieler, 2020 Colvin, 2011 Chambers - Fluoxetine, 1996 30.210.01.0

Publication bias and p-hacking diagnosis

funnel plot

Funnel plot not drawn. Less than 3 points.

Asymetry test p-value = NaN (by Egger's regression)

not enought points

p values plot

Funnel plot not drawn. Less than 3 points.

Sub-groups analysis using all included studies

excluded

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.07[0.77; 1.49]1,5283,7190%NAColvin, 2011 Chambers - Fluoxetine, 1996 2 unexposed, sick controlsunexposed, sick controls 0.99[0.90; 1.08]2,28928,434 -NAWall-Wieler, 2020 10.510.01.0