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

Severe congenital heart defect

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.
S11635
R42709		 Kolding (Controls unexposed, disease free), 2021 Severe cardiac malformations (cardiac malformations that end in miscarriage, termination, stillbirth, postnatal death or cardiac surgery <1 year of birth) 1st trimester population based cohort retrospective unexposed, disease free excluded Adjustment: Yes Monotherapy: no or not specified 1.09 [0.52;2.30]
excluded (control group) 		11/2,767   915/346,227 926 2,767
ref
S11636
R42712		 Kolding (Controls unexposed, sick), 2021 Severe cardiac malformations (cardiac malformations that end in miscarriage, termination, stillbirth, postnatal death or cardiac surgery <1 year of birth) 1st trimester population based cohort retrospective unexposed, sick Adjustment: No Monotherapy: no or not specified Unexposed sick: intermediate history of illness/treatment (3-12 months before pregnancy) 1.20 [0.58;2.48] 11/2,767   21/6,305 32 2,767
ref
S7348
R21404		 Wemakor, 2015 Severe congenital heart defect 1st trimester case control unexposed (general population or NOS) Adjustment: Yes Monotherapy: SSRI only 1.56 [1.02;2.39] 28/127   2,907/19,891 2,935 127
ref
Total 2 studies 1.46 [1.01;2.11] 2,967 2,894
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 Kolding (Controls unexposed, sick), 2021Kolding, 2021 1 1.20[0.58; 2.48]322,76726%ROB confusion: criticalROB selection: lowROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: moderate Wemakor, 2015Wemakor, 2015 1.56[1.02; 2.39]2,93512774%ROB confusion: criticalROB selection: criticalROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Total (2 studies) I2 = 0% 1.46[1.01; 2.11]2,9672,8940.55.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Controls unexposed, sick;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.20[0.58; 2.48]322,767 -NAKolding (Controls unexposed, sick), 2021 1 case control studiescase control studies 1.56[1.02; 2.39]2,935127 -NAWemakor, 2015 1 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.56[1.02; 2.39]2,935127 -NAWemakor, 2015 1 unexposed, sickunexposed, sick 1.20[0.58; 2.48]322,767 -NAKolding (Controls unexposed, sick), 2021 1 Tags Adjustment   - No  - No 1.20[0.58; 2.48]322,767 -NAKolding (Controls unexposed, sick), 2021 1   - Yes  - Yes 1.56[1.02; 2.39]2,935127 -NAWemakor, 2015 1 Monotherapy   - no or not specified  - no or not specified 1.20[0.58; 2.48]322,767 -NAKolding (Controls unexposed, sick), 2021 1   - SSRI only  - SSRI only 1.56[1.02; 2.39]2,935127 -NAWemakor, 2015 1 Unexposed sick   - intermediate history of illness/tre ...  - intermediate history of illness/treatment (3-12 months before pregnancy) 1.20[0.58; 2.48]322,767 -NAKolding (Controls unexposed, sick), 2021 1 All studiesAll studies 1.46[1.01; 2.11]2,9672,8940%NAKolding (Controls unexposed, sick), 2021 Wemakor, 2015 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 11635

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.43[0.99; 2.07]3,8612,8940%NAKolding (Controls unexposed, disease free), 2021 Wemakor, 2015 2 unexposed, sick controlsunexposed, sick controls 1.20[0.58; 2.48]322,767 -NAKolding (Controls unexposed, sick), 2021 10.510.01.0

Umbrella review (other published meta-analyses)

Published MAControlPeriodTE95% CIn exposedkI2 Gao - SSRI (Severe congenital heart defect)Gao - SSRI (Severe congenital heart defect) 2.28[0.88; 5.94]-U,GPunexposed (general population or NOS)T11st trimesterstudies TTT2 metaPregmetaPreg 1.46[1.01; 2.11]0%2,894----Kolding (Controls unexposed, sick), 2021 Wemakor, 2015 20.510.01.0