Sertraline updated on 07-01-2025

Assisted deliveries (forceps, vacuum, ...)

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.
S18438
R78183		 Lee (Controls exposed to TCAs), 2025 Instrumental delivery during pregnancy (anytime or not specified) retrospective cohort (claims database) exposed to other treatment, sick excluded Adjustment: No Monotherapy: substance alone among all Antidep (SSRI, SNRI, ...) 1.10 [0.74;1.63] C
excluded (control group) 		57/643   50/613 107 643
ref
S18420
R77941		 Lee (Controls unexposed, general pop), 2025 Instrumental delivery during pregnancy (anytime or not specified) retrospective cohort (claims database) unexposed (general population or NOS) Adjustment: Yes Monotherapy: substance alone among all Antidep (SSRI, SNRI, ...) 1.26 [0.95;1.66] 57/643   46,036/463,440 46,093 643
ref
S7699
R22859		 Kivistö, 2016 Vacuum assistance during pregnancy (anytime or not specified) retrospective cohort unexposed (general population or NOS) Adjustment: Yes Monotherapy: substance alone among all Antidep (SSRI, SNRI, ...) 1.70 [0.58;4.95] -/49   1,609/24,402 - 49
ref
Total 2 studies 1.28 [0.98;1.68] 46,093 692
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 Lee (Controls unexposed, general pop), 2025Lee, 2025 1 1.26[0.95; 1.66]46,09364394%ROB confusion: seriousROB selection: lowROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: moderate Kivistö, 2016Kivistö, 2016 1.70[0.58; 4.95]-496%ROB confusion: seriousROB selection: criticalROB classification: moderateROB missing: criticalROB mesure: moderateROB reporting: moderate Total (2 studies) I2 = 0% 1.28[0.98; 1.68]46,0936920.55.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Controls unexposed, general pop;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.28[0.98; 1.68]46,0936920%NALee (Controls unexposed, general pop), 2025 Kivistö, 2016 2 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.28[0.98; 1.68]46,0936920%NALee (Controls unexposed, general pop), 2025 Kivistö, 2016 2 Tags Adjustment   - Yes  - Yes 1.28[0.98; 1.68]46,0936920%NALee (Controls unexposed, general pop), 2025 Kivistö, 2016 2 Monotherapy   - substance alone among all Antidep ( ...  - substance alone among all Antidep (SSRI, SNRI, ...) 1.28[0.98; 1.68]46,0936920%NALee (Controls unexposed, general pop), 2025 Kivistö, 2016 2 All studiesAll studies 1.28[0.98; 1.68]46,0936920%NALee (Controls unexposed, general pop), 2025 Kivistö, 2016 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 18438

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.28[0.98; 1.68]47,6936920%NALee (Controls unexposed, general pop), 2025 Kivistö, 2016 2 exposed to other treatment, sick controlsexposed to other treatment, sick controls 1.10[0.74; 1.63]107643 -NALee (Controls exposed to TCAs), 2025 10.510.01.0