Escitalopram updated on 07-01-2025

Preterm (< 37 weeks)

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.
S18435
R78127
Lee (Controls exposed to TCAs), 2025 Preterm birth (infant born at gestational age <37 weeks) 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, ...) 1.05 [0.46;2.39] C
excluded (control group)
7/71   58/613 65 71
ref
S18414
R77822
Lee (Controls unexposed, general pop), 2025 Preterm birth (infant born at gestational age <37 weeks) 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, ...) 1.03 [0.47;2.26] 7/71   28,543/463,440 28,550 71
ref
S18219
R76441
Martin, 2024 Preterm delivery (delivery at <259 days (37 weeks’)) during pregnancy (anytime or not specified) population based cohort retrospective unexposed (general population or NOS) Adjustment: Yes Monotherapy: substance alone among all Antidep (SSRI, SNRI, ...) 1.16 [1.08;1.24] 1,015/15,406   119,950/2,408,707 120,965 15,406
ref
S13122
R50028
Marks (Controls exposed to Bupropion), 2021 Preterm Birth during pregnancy (anytime or not specified) retrospective cohort exposed to other treatment, sick Adjustment: No Monotherapy: substance alone among all Antidep (SSRI, SNRI, ...) 0.97 [0.68;1.38] C 85/581   61/406 146 581
ref
S7520
R22543
Ozturk, 2016 Preterm Births (<37 weeks) at least 1st trimester prospective cohort unexposed (general population or NOS) Adjustment: No Monotherapy: no or not specified 1.03 [0.12;8.50] C 1/30   8/246 9 30
ref
S6190
R16314
Klieger-Grossmann, 2012 Premature birth (< 37 weeks's gestation) during pregnancy (anytime or not specified) prospective cohort unexposed (general population or NOS) Adjustment: No Matched Monotherapy: substance alone among all Antidep (SSRI, SNRI, ...) 2.51 [1.10;5.71] C 19/172   9/191 28 172
ref
Total 5 studies 1.15 [1.00;1.33] 149,698 16,260
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 1.03[0.47; 2.26]28,550713%ROB confusion: seriousROB selection: lowROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: moderate Martin, 2024Martin, 2024 1.16[1.08; 1.24]120,96515,40679%ROB confusion: seriousROB selection: lowROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Marks (Controls exposed to Bupropion), 2021Marks, 2021 2 0.97[0.68; 1.38]14658114%ROB confusion: criticalROB selection: lowROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Ozturk, 2016Ozturk, 2016 1.03[0.12; 8.50]9300%ROB confusion: criticalROB selection: unclearROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Klieger-Grossmann, 2012Klieger-Grossmann, 2012 2.51[1.10; 5.71]281723%ROB confusion: criticalROB selection: moderateROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Total (5 studies) I2 = 10% 1.15[1.00; 1.33]149,69816,2600.210.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Controls unexposed, general pop; 2: Controls exposed to Bupropion;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.15[1.00; 1.33]149,69816,26010%NALee (Controls unexposed, general pop), 2025 Martin, 2024 Marks (Controls exposed to Bupropion), 2021 Ozturk, 2016 Klieger-Grossmann, 2012 5 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.22[0.95; 1.57]149,55215,67914%NALee (Controls unexposed, general pop), 2025 Martin, 2024 Ozturk, 2016 Klieger-Grossmann, 2012 4 exposed to other treatment, sickexposed to other treatment, sick 0.97[0.68; 1.38]146581 -NAMarks (Controls exposed to Bupropion), 2021 1 Tags Adjustment   - No  - No 1.36[0.66; 2.80]18378354%NAMarks (Controls exposed to Bupropion), 2021 Ozturk, 2016 Klieger-Grossmann, 2012 3   - Yes  - Yes 1.16[1.08; 1.24]149,51515,4770%NALee (Controls unexposed, general pop), 2025 Martin, 2024 2 MatchedMatched 2.51[1.10; 5.71]28172 -NAKlieger-Grossmann, 2012 1 Monotherapy   - no or not specified  - no or not specified 1.03[0.12; 8.50]930 -NAOzturk, 2016 1   - substance alone among all Antidep ( ...  - substance alone among all Antidep (SSRI, SNRI, ...) 1.16[0.93; 1.44]149,68916,23033%NALee (Controls unexposed, general pop), 2025 Martin, 2024 Marks (Controls exposed to Bupropion), 2021 Klieger-Grossmann, 2012 4 All studiesAll studies 1.15[1.00; 1.33]149,69816,26010%NALee (Controls unexposed, general pop), 2025 Martin, 2024 Marks (Controls exposed to Bupropion), 2021 Ozturk, 2016 Klieger-Grossmann, 2012 50.210.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-2.52.71.2940.000Lee (Controls unexposed, general pop), 2025Martin, 2024Marks (Controls exposed to Bupropion), 2021Ozturk, 2016Klieger-Grossmann, 2012

Asymetry test p-value = 0.8199 (by Egger's regression)

slope=0.1383 (0.0523); intercept=0.1692 (0.6813); t=0.2483; p=0.8199

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded 18435

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.22[0.95; 1.57]149,55215,67914%NALee (Controls unexposed, general pop), 2025 Martin, 2024 Ozturk, 2016 Klieger-Grossmann, 2012 4 exposed to other treatment, sick controlsexposed to other treatment, sick controls 0.98[0.71; 1.36]2116520%NALee (Controls exposed to TCAs), 2025 Marks (Controls exposed to Bupropion), 2021 20.510.01.0