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

Atrial 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
R77154		 Chan (Controls unexposed, sick), 2024 Atrial septal defect (ASD) 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 3.82 [1.16;12.61] 3/66   55/4,413 58 66
ref
S18315
R77130		 Chan - SNRI (Controls exposed to TCA), 2024 Atrial septal defect (ASD) 1st trimester retrospective cohort (claims database) exposed to other treatment, sick excluded Adjustment: No Monotherapy: SNRI only 1.91 [0.57;6.36] C
excluded (control group) 		4/77   9/322 13 77
ref
S18316
R77142		 Chan - SNRI (Controls unexposed, general pop), 2024 Atrial septal defect (ASD) 1st trimester retrospective cohort (claims database) unexposed (general population or NOS) excluded Adjustment: Yes Monotherapy: SNRI only 4.46 [1.35;14.71]
excluded (control group) 		4/77   4,755/462,377 4,759 77
ref
S11771
R43262		 Anderson - SNRI, 2020 Atrial septal defect (ASD) – secundum type 1st trimester case control unexposed (general population or NOS) Adjustment: Yes Monotherapy: SNRI only 2.11 [1.01;4.42] -/-   0/- - -
ref
Total 2 studies 2.49 [1.33;4.66] 58 66
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 3.82[1.16; 12.61]586628%ROB confusion: seriousROB selection: moderateROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Anderson - SNRI, 2020Anderson - SNRI, 2020 2.11[1.01; 4.42]--72%ROB confusion: seriousROB selection: criticalROB classification: criticalROB missing: lowROB mesure: criticalROB reporting: moderate Total (2 studies) I2 = 0% 2.49[1.33; 4.66]58660.910.01.0ROB: 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 3.82[1.16; 12.59]5866 -NAChan (Controls unexposed, sick), 2024 1 case control studiescase control studies 2.11[1.01; 4.41]-- -NAAnderson - SNRI, 2020 1 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 2.11[1.01; 4.41]-- -NAAnderson - SNRI, 2020 1 unexposed, sickunexposed, sick 3.82[1.16; 12.59]5866 -NAChan (Controls unexposed, sick), 2024 1 Tags Adjustment   - Yes  - Yes 2.49[1.33; 4.66]58660%NAChan (Controls unexposed, sick), 2024 Anderson - SNRI, 2020 2 Monotherapy   - SNRI only  - SNRI only 2.49[1.33; 4.66]58660%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 3.82[1.16; 12.59]5866 -NAChan (Controls unexposed, sick), 2024 1 All studiesAll studies 2.49[1.33; 4.66]58660%NAChan (Controls unexposed, sick), 2024 Anderson - SNRI, 2020 20.510.01.0

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 18315, 18316

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 2.63[1.35; 5.14]4,759778%NAChan - SNRI (Controls unexposed, general pop), 2024 Anderson - SNRI, 2020 2 unexposed, sick controlsunexposed, sick controls 3.82[1.16; 12.59]5866 -NAChan (Controls unexposed, sick), 2024 1 exposed to other treatment, sick controlsexposed to other treatment, sick controls 1.91[0.57; 6.36]1377 -NAChan - SNRI (Controls exposed to TCA), 2024 10.510.01.0