Serotonin and Noradrenaline Reuptake Inhibitors (SNRI) updated on 07-01-2025

Ventricular septal defect

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.
S18317
R77153
Chan (Controls unexposed, sick), 2024 Ventral septal defect (VSD) 1st trimester retrospective cohort (claims database) unexposed, sick Adjustment: Yes Monotherapy: SNRI only Unexposed sick: old history of illness/treatment (> 12 months before pregnancy) or not specified 2.01 [0.27;15.00] 1/66   32/4,413 33 66
ref
S18315
R77129
Chan - SNRI (Controls exposed to TCA), 2024 Ventral septal defect (VSD) 1st trimester retrospective cohort (claims database) exposed to other treatment, sick excluded Adjustment: No Monotherapy: SNRI only 1.40 [0.14;13.64] C
excluded (control group)
1/77   3/322 4 77
ref
S18316
R77141
Chan - SNRI (Controls unexposed, general pop), 2024 Ventral septal defect (VSD) 1st trimester retrospective cohort (claims database) unexposed (general population or NOS) excluded Adjustment: Yes Monotherapy: SNRI only 0.84 [0.04;15.88]
excluded (control group)
1/77   2,586/462,377 2,587 77
ref
S11771
R43260
Anderson - SNRI, 2020 Ventricular septal defect (VSD) – perimembranous type 1st trimester case control unexposed (general population or NOS) Adjustment: Yes Monotherapy: SNRI only 2.06 [0.89;4.78] -/-   0/- - -
ref
S11718
R43074
Huybrechts - SNRI (Controls unexposed, NOS), 2014 Ventricular Septal Defect 1st trimester cohort unexposed (general population or NOS) excluded Adjustment: No Monotherapy: no or not specified 1.56 [1.14;2.14]
excluded (control group)
39/6,904   3,212/885,115 3,251 6,904
ref
S11719
R43078
Huybrechts - SNRI (Controls unexposed, sick), 2014 Ventricular Septal Defect 1st trimester cohort unexposed, sick Adjustment: Yes Monotherapy: no or not specified Unexposed sick: old history of illness/treatment (> 12 months before pregnancy) or not specified 1.18 [0.80;1.73] 34/5,993   751/180,564 785 5,993
ref
Total 3 studies 1.32 [0.93;1.86] 818 6,059
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 Chan (Controls unexposed, sick), 2024Chan, 2024 1 2.01[0.27; 15.00]33663%ROB confusion: seriousROB selection: moderateROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Anderson - SNRI, 2020Anderson - SNRI, 2020 2.06[0.89; 4.78]--17%ROB confusion: seriousROB selection: criticalROB classification: criticalROB missing: lowROB mesure: criticalROB reporting: moderate Huybrechts - SNRI (Controls unexposed, sick), 2014Huybrechts - SNRI, 2014 2 1.18[0.80; 1.73]7855,99380%ROB confusion: moderateROB selection: lowROB classification: moderateROB missing: moderateROB mesure: moderateROB reporting: moderate Total (3 studies) I2 = 0% 1.32[0.93; 1.86]8186,0590.55.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Controls unexposed, sick; 2: Controls unexposed, sick;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.20[0.82; 1.76]8186,0590%NAChan (Controls unexposed, sick), 2024 Huybrechts - SNRI (Controls unexposed, sick), 2014 2 case control studiescase control studies 2.06[0.89; 4.77]-- -NAAnderson - SNRI, 2020 1 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 2.06[0.89; 4.77]-- -NAAnderson - SNRI, 2020 1 unexposed, sickunexposed, sick 1.20[0.82; 1.76]8186,0590%NAChan (Controls unexposed, sick), 2024 Huybrechts - SNRI (Controls unexposed, sick), 2014 2 Tags Adjustment   - Yes  - Yes 1.32[0.93; 1.86]8186,0590%NAChan (Controls unexposed, sick), 2024 Anderson - SNRI, 2020 Huybrechts - SNRI (Controls unexposed, sick), 2014 3 Monotherapy   - no or not specified  - no or not specified 1.18[0.80; 1.74]7855,993 -NAHuybrechts - SNRI (Controls unexposed, sick), 2014 1   - SNRI only  - SNRI only 2.05[0.95; 4.46]33660%NAChan (Controls unexposed, sick), 2024 Anderson - SNRI, 2020 2 Unexposed sick   - old history of illness/treatment (> ...  - old history of illness/treatment (> 12 months before pregnancy) or not specified 1.20[0.82; 1.76]8186,0590%NAChan (Controls unexposed, sick), 2024 Huybrechts - SNRI (Controls unexposed, sick), 2014 2 All studiesAll studies 1.32[0.93; 1.86]8186,0590%NAChan (Controls unexposed, sick), 2024 Anderson - SNRI, 2020 Huybrechts - SNRI (Controls unexposed, sick), 2014 30.55.01.0

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 11718, 18315, 18316

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.60[1.20; 2.15]5,8386,9810%NAChan - SNRI (Controls unexposed, general pop), 2024 Anderson - SNRI, 2020 Huybrechts - SNRI (Controls unexposed, NOS), 2014 3 unexposed, sick controlsunexposed, sick controls 1.20[0.82; 1.76]8186,0590%NAChan (Controls unexposed, sick), 2024 Huybrechts - SNRI (Controls unexposed, sick), 2014 2 exposed to other treatment, sick controlsexposed to other treatment, sick controls 1.40[0.14; 13.64]477 -NAChan - SNRI (Controls exposed to TCA), 2024 10.510.01.0