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

Very low Apgar score (< 5) (at 1 min)

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.
S5379
R17678		 Roca, 2011 Apgar score minute 1≤5 during pregnancy (anytime or not specified) prospective cohort unexposed, disease free Adjustment: No Matched Monotherapy: no or not specified 1.34 [0.22;8.19] C 2/84   3/168 5 84
ref
S6994
R19831		 Simon (Controls exposed to TCA), 2002 Apgar score at 1 minute ≤5 during pregnancy (anytime or not specified) retrospective cohort (claims database) exposed to other treatment, sick excluded Adjustment: No Monotherapy: SSRI only 2.38 [1.21;4.69] C
excluded (control group) 		27/185   14/209 41 185
ref
S492
R17419		 Simon (Controls unexposed, NOS), 2002 Apgar score at 1 minute ≤5 during pregnancy (anytime or not specified) retrospective cohort (claims database) unexposed (general population or NOS) Adjustment: Yes Matched Monotherapy: SSRI only 1.61 [0.82;3.16] 27/185   17/185 44 185
ref
Total 2 studies 1.57 [0.84;2.96] 49 269
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 Roca, 2011Roca, 2011 1.34[0.22; 8.19]58412%ROB confusion: criticalROB selection: criticalROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Simon (Controls unexposed, NOS), 2002Simon, 2002 1 1.61[0.82; 3.16]4418588%ROB confusion: seriousROB selection: lowROB classification: criticalROB missing: unclearROB mesure: moderateROB reporting: moderate Total (2 studies) I2 = 0% 1.57[0.84; 2.96]492690.55.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Controls unexposed, NOS;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.57[0.84; 2.96]492690%NARoca, 2011 Simon (Controls unexposed, NOS), 2002 2 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.57[0.84; 2.96]492690%NARoca, 2011 Simon (Controls unexposed, NOS), 2002 2 Tags Adjustment   - No  - No 1.34[0.22; 8.19]584 -NARoca, 2011 1   - Yes  - Yes 1.61[0.82; 3.16]44185 -NASimon (Controls unexposed, NOS), 2002 1 MatchedMatched 1.57[0.84; 2.96]492690%NARoca, 2011 Simon (Controls unexposed, NOS), 2002 2 Monotherapy   - no or not specified  - no or not specified 1.34[0.22; 8.19]584 -NARoca, 2011 1   - SSRI only  - SSRI only 1.61[0.82; 3.16]44185 -NASimon (Controls unexposed, NOS), 2002 1 All studiesAll studies 1.57[0.84; 2.96]492690%NARoca, 2011 Simon (Controls unexposed, NOS), 2002 20.55.01.0

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 6994

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.57[0.84; 2.96]492690%NARoca, 2011 Simon (Controls unexposed, NOS), 2002 2 exposed to other treatment, sick controlsexposed to other treatment, sick controls 2.38[1.21; 4.69]41185 -NASimon (Controls exposed to TCA), 2002 10.510.01.0