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

Severe cognitive developmental delay (Mental retardation) (> 6 years old)

id	Study   Auto Heuvelman, 2023Liu, 2017Viktorin, 2017	Lib. in paper	Exposition period  Auto during pregnancy (anytime or not specified)1st trimester2nd trimester3rd trimester2nd and/or 3rd trimesterthroughout pregnancyearly pregnancydays before deliverylate pregnancypreconception-onlypericonceptionalpreconceptional for kinetic reasonat least 1st trimester3 months (or more) before pregnancy or during pregnancy1st and 2nd trimester3 months or more before pregnancy or1st trimesterPaternal exp. genotoxic window only (0–3 months preconception)Paternal exposure: epigenetic window only (3–xxx months preconception)Paternal exposure: genotoxic/epigenetic window (0–xxx months preconception)Paternal exposure: other window	Study type  All studies Case control excluded Only case control	Control type    Auto unexposed (general population or NOS)unexposed, sickunexposed, disease freeexposed to other treatment, sicknot specifiedsiblingwhatever (meta-analysis)	Tags	OR 95%CI	x1/n1 x0/n0	no cases	no exposed	ROB	Ref.
S18372 R77449	Heuvelman, 2023	Intellectual disability - Validated Read code list among primary care clinical and referral records - Mean age at end of follow-up 10.04 years, range 4–22 years	during pregnancy (anytime or not specified)	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)	0.82 [0.56;1.21]	-/12,093   -/16,330	-	12,093		ref
S7551 R22739	Liu, 2017	Mental retardation (ICD-10 codes F70-F79) in the offspring (mean age at diagnosis: 8.5 years)	during pregnancy (anytime or not specified)	population based cohort retrospective	unexposed, sick	Adjustment: Yes Monotherapy: SSRI only Unexposed sick: old history of illness/treatment (> 12 months before pregnancy) or not specified	1.32 [0.83;2.11]	28/13,501   53/30,079	81	13,501		ref
S7455 R22010	Viktorin, 2017	Intellectual Disability (ICD-10 codes of F70 to F79) - At least 7 years old	during pregnancy (anytime or not specified)	population based cohort retrospective	unexposed (general population or NOS)	Adjustment: Yes Monotherapy: no or not specified	1.48 [0.98;2.23]	-/3,178   -/172,646	-	3,178		ref
					Total	3 studies	1.16 [0.80;1.68]		81	28,772
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

Sensitivity analysis

Publication bias and p-hacking diagnosis

Sub-groups analysis using all included studies

excluded