Bupropion (All indications except smoking cessation) updated on 07-01-2025

Congenital heart defects

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.
S13149
R50203		 Marks (Controls exposed to Sertraline), 2021 Cardiac Malformations during pregnancy (anytime or not specified) excluded retrospective cohort exposed to other treatment, sick Adjustment: No Indications Bupropion: Any or not mentioned Monotherapy: substance alone among all Antidep (SSRI, SNRI, ...) 0.82 [0.45;1.51] C
excluded (exposition period) 		13/406   64/1,653 77 406
ref
S12927
R49043		 Anderson, 2020 Any heart defect 1st trimester case control unexposed (general population or NOS) Adjustment: Yes Indications Bupropion: Any or not mentioned Monotherapy: substance alone among all Antidep (SSRI, SNRI, ...) 1.24 [0.83;1.84] -/-   0/- - -
ref
S11716
R43064		 Huybrechts (Controls unexposed, NOS), 2014 Any cardiac malformations 1st trimester retrospective cohort (claims database) unexposed (general population or NOS) excluded Adjustment: No Indications Bupropion: Any or not mentioned Monotherapy: no or not specified 1.19 [0.95;1.49]
excluded (control group) 		76/8,856   6,403/885,115 6,479 8,856
ref
S11717
R43068		 Huybrechts (Controls unexposed, sick), 2014 Any cardiac malformations 1st trimester cohort unexposed, sick Adjustment: Yes Indications Bupropion: Depression, mood or anxiety disorders Monotherapy: no or not specified Unexposed sick: old history of illness/treatment (> 12 months before pregnancy) or not specified 0.95 [0.71;1.26] 57/6,698   1,497/180,563 1,554 6,698
ref
S12933
R49086		 Cole, 2007 Cardiovascular malformations 1st trimester retrospective cohort (claims database) exposed to other treatment, sick Adjustment: Yes Indications Bupropion: Any or not mentioned Monotherapy: no or not specified 0.97 [0.52;1.80] 13/1,213   51/4,743 64 1,213
ref
Total 3 studies 1.03 [0.83;1.28] 1,618 7,911
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 Anderson, 2020Anderson, 2020 1.24[0.83; 1.84]--30%ROB confusion: seriousROB selection: criticalROB classification: criticalROB missing: lowROB mesure: criticalROB reporting: moderate Huybrechts (Controls unexposed, sick), 2014Huybrechts, 2014 1 0.95[0.71; 1.26]1,5546,69858%ROB confusion: moderateROB selection: lowROB classification: moderateROB missing: moderateROB mesure: moderateROB reporting: moderate Cole, 2007Cole, 2007 0.97[0.52; 1.80]641,21312%ROB confusion: criticalROB selection: criticalROB classification: criticalROB missing: unclearROB mesure: criticalROB reporting: moderate Total (3 studies) I2 = 0% 1.03[0.83; 1.28]1,6187,9110.25.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Controls unexposed, sick;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 0.95[0.73; 1.24]1,6187,9110%NAHuybrechts (Controls unexposed, sick), 2014 Cole, 2007 2 case control studiescase control studies 1.24[0.83; 1.85]-- -NAAnderson, 2020 1 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.24[0.83; 1.85]-- -NAAnderson, 2020 1 unexposed, sickunexposed, sick 0.95[0.71; 1.27]1,5546,698 -NAHuybrechts (Controls unexposed, sick), 2014 1 exposed to other treatment, sickexposed to other treatment, sick 0.97[0.52; 1.80]641,213 -NACole, 2007 1 Tags Adjustment   - Yes  - Yes 1.03[0.83; 1.28]1,6187,9110%NAAnderson, 2020 Huybrechts (Controls unexposed, sick), 2014 Cole, 2007 3 Indications Bupropion   - Any or not mentioned  - Any or not mentioned 1.15[0.83; 1.61]641,2130%NAAnderson, 2020 Cole, 2007 2   - Depression, mood or anxiety disorders  - Depression, mood or anxiety disorders 0.95[0.71; 1.27]1,5546,698 -NAHuybrechts (Controls unexposed, sick), 2014 1 Monotherapy   - no or not specified  - no or not specified 0.95[0.73; 1.24]1,6187,9110%NAHuybrechts (Controls unexposed, sick), 2014 Cole, 2007 2   - substance alone among all Antidep ( ...  - substance alone among all Antidep (SSRI, SNRI, ...) 1.24[0.83; 1.85]-- -NAAnderson, 2020 1 Unexposed sick   - old history of illness/treatment (> ...  - old history of illness/treatment (> 12 months before pregnancy) or not specified 0.95[0.71; 1.27]1,5546,698 -NAHuybrechts (Controls unexposed, sick), 2014 1 All studiesAll studies 1.03[0.83; 1.28]1,6187,9110%NAAnderson, 2020 Huybrechts (Controls unexposed, sick), 2014 Cole, 2007 30.25.01.0

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 11716

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.20[0.99; 1.46]6,4798,8560%NAAnderson, 2020 Huybrechts (Controls unexposed, NOS), 2014 2 unexposed, sick controlsunexposed, sick controls 0.95[0.71; 1.27]1,5546,698 -NAHuybrechts (Controls unexposed, sick), 2014 1 exposed to other treatment, sick controlsexposed to other treatment, sick controls 0.97[0.52; 1.80]641,213 -NACole, 2007 10.510.01.0

Umbrella review (other published meta-analyses)

Published MAControlPeriodTE95% CIn exposedkI2 De Vries (Congenital Heart Defects)De Vries (Congenital Heart Defects) 1.23[1.01; 1.49]0%-Wwhatever (meta-analysis)T11st trimesterstudies TTT3 metaPregmetaPreg 1.03[0.83; 1.28]0%7,911----Anderson, 2020 Huybrechts (Controls unexposed, sick), 2014 Cole, 2007 30.510.01.0