Citalopram updated on 07-01-2025

Preterm (< 37 weeks)

id	Study   Auto Lee (Controls exposed to TCAs), 2025Lee (Controls unexposed, general pop), 2025Martin, 2024Marks (Controls exposed to Bupropion), 2021Kivistö, 2016Ozturk, 2016Colvin, 2011Sivojelezova (Control exposed to other SSRI), 2005Sivojelezova (Control unexposed, NOS), 2005	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.
S18431 R78043	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, ...)	1.66 [0.85;3.25] C excluded (control group)	12/81   58/613	70	81		ref
S18412 R77780	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, ...)	1.47 [0.79;2.72]	12/81   28,543/463,440	28,555	81		ref
S18217 R76435	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 [1.10;1.24]	1,392/20,869   119,950/2,408,707	121,342	20,869		ref
S13120 R50016	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, ...)	0.96 [0.65;1.43] C	56/385   61/406	117	385		ref
S7696 R22837	Kivistö, 2016	Preterm delivery (birth before 37 completed weeks)	during pregnancy (anytime or not specified)	retrospective cohort	unexposed (general population or NOS)	Adjustment: Yes Monotherapy: substance alone among all Antidep (SSRI, SNRI, ...)	1.21 [0.75;1.96]	-/215   1,909/24,402	-	215		ref
S7527 R22571	Ozturk, 2016	Preterm Births (<37 weeks)	at least 1st trimester	prospective cohort	unexposed (general population or NOS)	Adjustment: No Monotherapy: no or not specified	9.31 [0.35;245.79] C	0/2   8/246	8	2		ref
S7179 R20187	Colvin, 2011	Preterm birth (<37 weeks)	during pregnancy (anytime or not specified)	retrospective cohort (claims database)	unexposed (general population or NOS)	Adjustment: Yes Monotherapy: substance alone among the specific class of antidep (SSRI, SNRI, ...)	1.38 [1.08;1.77]	132/1,136   7,480/92,995	7,612	1,136		ref
S6415 R17607	Sivojelezova (Control exposed to other SSRI), 2005	Preterm (<37 wk)	during pregnancy (anytime or not specified)	prospective cohort	exposed to other treatment, sick excluded	Adjustment: No Matched Monotherapy: no or not specified	1.12 [0.46;2.75] C excluded (control group)	11/114   10/115	21	114		ref
S6414 R17599	Sivojelezova (Control unexposed, NOS), 2005	Preterm (<37 wk)	during pregnancy (anytime or not specified)	prospective cohort	unexposed (general population or NOS)	Adjustment: No Matched Monotherapy: no or not specified	2.35 [0.79;6.99] C	11/114   5/115	16	114		ref
					Total	7 studies	1.19 [1.09;1.30]		157,650	22,802
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 6415, 18431

Umbrella review (other published meta-analyses)