Citalopram updated on 07-01-2025

Early intrauterine deaths (< 22 weeks) / Spontaneous abortions

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.
S12958
R49167		 Kitchin, 2022 Miscarriage (pregnancy losses between 4-22 weeks) 1st trimester case control unexposed (general population or NOS) Adjustment: Yes Monotherapy: no or not specified 1.07 [0.65;1.77] 22/74   18,048/72,205 18,070 74
ref
S7527
R22570		 Ozturk, 2016 Miscarriages at least 1st trimester prospective cohort unexposed (general population or NOS) Adjustment: No Monotherapy: no or not specified 5.28 [0.21;135.02] C 0/2   15/261 15 2
ref
S7866
R23809		 Andersen, 2014 Miscarriage (O021 and O03) early pregnancy population based cohort retrospective unexposed (general population or NOS) Adjustment: Yes Monotherapy: no or not specified 1.29 [1.21;1.37] -/9,927   139,210/1,256,956 - 9,927
ref
S8178
R25339		 Nakhai-Pour, 2010 Spontaneous abortions (< 20th week of gestation) during pregnancy (anytime or not specified) nested case control unexposed (general population or NOS) Adjustment: Yes Matched Monotherapy: substance alone among all Antidep (SSRI, SNRI, ...) 1.55 [0.89;2.68] 19/-   5,105/- 5,124 -
ref
S6415
R17603		 Sivojelezova (Control exposed to other SSRI), 2005 Spontaneous abortion during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick excluded Adjustment: No Matched Monotherapy: no or not specified 1.09 [0.49;2.41] C
excluded (control group) 		14/132   13/132 27 132
ref
S6414
R17595		 Sivojelezova (Control unexposed, NOS), 2005 Spontaneous abortion during pregnancy (anytime or not specified) prospective cohort unexposed (general population or NOS) Adjustment: No Matched Monotherapy: no or not specified 1.09 [0.49;2.41] C 14/132   13/132 27 132
ref
S7880
R23828		 Yaris, 2005 Spontaneous abortions during pregnancy (anytime or not specified) prospective cohort unexposed (general population or NOS) Adjustment: No Monotherapy: no or not specified 1.93 [0.10;36.85] C 0/7   9/248 9 7
ref
Total 6 studies 1.29 [1.21;1.37] 23,245 10,142
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 Kitchin, 2022Kitchin, 2022 1.07[0.65; 1.77]18,070741%ROB confusion: seriousROB selection: lowROB classification: criticalROB missing: unclearROB mesure: criticalROB reporting: moderate Ozturk, 2016Ozturk, 2016 5.28[0.21; 135.02]1520%ROB confusion: criticalROB selection: unclearROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Andersen, 2014Andersen, 2014 1.29[1.21; 1.37]-9,92797%ROB confusion: criticalROB selection: lowROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Nakhai-Pour, 2010Nakhai-Pour, 2010 1.55[0.89; 2.68]5,124-1%ROB confusion: seriousROB selection: lowROB classification: criticalROB missing: unclearROB mesure: criticalROB reporting: moderate Sivojelezova (Control unexposed, NOS), 2005Sivojelezova, 2005 1 1.09[0.49; 2.41]271321%ROB confusion: criticalROB selection: moderateROB classification: moderateROB missing: unclearROB mesure: criticalROB reporting: moderate Yaris, 2005Yaris, 2005 1.93[0.10; 36.85]970%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Total (6 studies) I2 = 0% 1.29[1.21; 1.37]23,24510,1420.520.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Control unexposed, NOS;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.29[1.21; 1.37]5110,0680%NAOzturk, 2016 Andersen, 2014 Sivojelezova (Control unexposed, NOS), 2005 Yaris, 2005 4 case control studiescase control studies 1.27[0.87; 1.83]23,194740%NAKitchin, 2022 Nakhai-Pour, 2010 2 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.29[1.21; 1.37]23,24510,1420%NAKitchin, 2022 Ozturk, 2016 Andersen, 2014 Nakhai-Pour, 2010 Sivojelezova (Control unexposed, NOS), 2005 Yaris, 2005 6 Tags Adjustment   - No  - No 1.23[0.58; 2.59]511410%NAOzturk, 2016 Sivojelezova (Control unexposed, NOS), 2005 Yaris, 2005 3   - Yes  - Yes 1.29[1.21; 1.37]23,19410,0010%NAKitchin, 2022 Andersen, 2014 Nakhai-Pour, 2010 3 MatchedMatched 1.38[0.88; 2.17]5,1511320%NANakhai-Pour, 2010 Sivojelezova (Control unexposed, NOS), 2005 2 Monotherapy   - no or not specified  - no or not specified 1.29[1.21; 1.37]18,12110,1420%NAKitchin, 2022 Ozturk, 2016 Andersen, 2014 Sivojelezova (Control unexposed, NOS), 2005 Yaris, 2005 5   - substance alone among all Antidep ( ...  - substance alone among all Antidep (SSRI, SNRI, ...) 1.55[0.89; 2.69]5,124- -NANakhai-Pour, 2010 1 All studiesAll studies 1.29[1.21; 1.37]23,24510,1420%NAKitchin, 2022 Ozturk, 2016 Andersen, 2014 Nakhai-Pour, 2010 Sivojelezova (Control unexposed, NOS), 2005 Yaris, 2005 60.520.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-3.94.11.9850.000Kitchin, 2022Ozturk, 2016Andersen, 2014Nakhai-Pour, 2010Sivojelezova (Control unexposed, NOS), 2005Yaris, 2005

Asymetry test p-value = 0.6627 (by Egger's regression)

slope=0.2474 (0.0251); intercept=0.1550 (0.3296); t=0.4702; p=0.6627

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded 6415

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.29[1.21; 1.37]162,44610,1520%NAKitchin, 2022 Ozturk, 2016 Andersen, 2014 Nakhai-Pour, 2010 Sivojelezova (Control unexposed, NOS), 2005 Yaris, 2005 6 exposed to other treatment, sick controlsexposed to other treatment, sick controls 1.09[0.49; 2.41]27132 -NASivojelezova (Control exposed to other SSRI), 2005 10.510.01.0

Umbrella review (other published meta-analyses)

Published MAControlPeriodTE95% CIn exposedkI2 Xing (Spontaneous abortion)Xing (Spontaneous abortion) 1.35[1.22; 1.49]67%-Wwhatever (meta-analysis)Anyduring pregnancy (anytime or not specified)studies TTT3 metaPregmetaPreg 1.29[1.21; 1.37]0%10,142----Kitchin, 2022 Ozturk, 2016 Andersen, 2014 Nakhai-Pour, 2010 Sivojelezova (Control unexposed, NOS), 2005 Yaris, 2005 60.510.01.0