Amitriptyline updated on 07-01-2025

Low Apgar score (< 7) (at 5 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.
S18423
R77979
Lee (Controls exposed to SSRI), 2025 5-minute Apgar score<7 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, ...) 3.93 [1.05;14.73] C
excluded (control group)
4/301   5/1,465 9 301
ref
S18411
R77764
Lee (Controls unexposed, general pop), 2025 5-minute Apgar score<7 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, ...) 2.49 [0.91;6.81] 4/301   1,721/463,440 1,725 301
ref
S18306
R77095
Martin, 2024 Low Apgar score at 5 min (<7) 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, ...) 0.94 [0.70;1.26] 51/2,899   30,996/2,078,011 31,047 2,899
ref
Total 2 studies 1.35 [0.54;3.40] 32,772 3,200
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 2.49[0.91; 6.81]1,72530137%ROB confusion: moderateROB selection: lowROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: moderate Martin, 2024Martin, 2024 0.94[0.70; 1.26]31,0472,89963%ROB confusion: seriousROB selection: lowROB classification: criticalROB missing: unclearROB mesure: moderateROB reporting: moderate Total (2 studies) I2 = 70% 1.35[0.54; 3.40]32,7723,2000.25.01.0ROB: 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 1.35[0.54; 3.40]32,7723,20070%NALee (Controls unexposed, general pop), 2025 Martin, 2024 2 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.35[0.54; 3.40]32,7723,20070%NALee (Controls unexposed, general pop), 2025 Martin, 2024 2 Tags Adjustment   - Yes  - Yes 1.35[0.54; 3.40]32,7723,20070%NALee (Controls unexposed, general pop), 2025 Martin, 2024 2 Monotherapy   - substance alone among all Antidep ( ...  - substance alone among all Antidep (SSRI, SNRI, ...) 1.35[0.54; 3.40]32,7723,20070%NALee (Controls unexposed, general pop), 2025 Martin, 2024 2 All studiesAll studies 1.35[0.54; 3.40]32,7723,20070%NALee (Controls unexposed, general pop), 2025 Martin, 2024 20.25.01.0

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 18423

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.35[0.54; 3.40]32,7723,20070%NALee (Controls unexposed, general pop), 2025 Martin, 2024 2 exposed to other treatment, sick controlsexposed to other treatment, sick controls 3.93[1.05; 14.73]9301 -NALee (Controls exposed to SSRI), 2025 10.510.01.0