Serotonin and Noradrenaline Reuptake Inhibitors (SNRI) - Medication and Pregnancy KB

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

Cardiac septal defects

R analysis

id	Study	Lib. in paper	Exposition period	Study type All studies Case control excluded Only case control	Control type	Tags	OR 95%CI	x1/n1 x0/n0	no cases	no exposed	ROB	Ref.
S18317 R77152	Chan (Controls unexposed, sick), 2024	Cardiac septal defect	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	2.79 [0.85;9.14]	3/66 74/4,413	77	66		ref
S18315 R77128	Chan - SNRI (Controls exposed to TCA), 2024	Cardiac septal defect	1st trimester	retrospective cohort (claims database)	exposed to other treatment, sick excluded	Adjustment: No Monotherapy: SNRI only	1.71 [0.52;5.60] ^C excluded (control group)	4/77 10/322	14	77		ref
S18316 R77140	Chan - SNRI (Controls unexposed, general pop), 2024	Cardiac septal defect	1st trimester	retrospective cohort (claims database)	unexposed (general population or NOS) excluded	Adjustment: Yes Monotherapy: SNRI only	1.95 [0.43;8.79] excluded (control group)	4/77 6,299/462,377	6,303	77		ref
S11771 R43259	Anderson - SNRI, 2020	Septal defects	1st trimester	case control	unexposed (general population or NOS)	Adjustment: Yes Monotherapy: SNRI only	2.11 [1.17;3.81]	-/- 0/-	-	-		ref
S11696 R43033	Bérard b - SNRI=Venlafaxine (Controls unexposed, sick), 2017	Ventricular/atrial septal defect	1st trimester	retrospective cohort (claims database)	unexposed, sick	Adjustment: Yes Monotherapy: SNRI only Unexposed sick: intermediate history of illness/treatment (3-12 months before pregnancy)	0.73 [0.39;1.39]	-/738 -/14,847	-	738		ref
S11688 R42976	Furu - Venlafaxine, 2015	Atrial and ventricular septal defects	1st trimester	population based cohort retrospective	unexposed (general population or NOS)	Adjustment: Yes Monotherapy: SNRI only	1.10 [0.73;1.64]	25/2,763 17,503/2,266,875	17,528	2,763		ref
S11693 R76991	Reis - SNRI (Controls exposed to TCA), 2010	Ventricular septal defect (VSD) and/or atrial septal defect (ASD)	1st trimester	population based cohort retrospective	exposed to other treatment, sick excluded	Adjustment: No Monotherapy: SNRI only	0.79 [0.37;1.70] ^C excluded (control group)	11/1,351 17/1,662	28	1,351		ref
S11694 R76986	Reis - SNRI (Controls unexposed, NOS), 2010	Ventricular septal defect (VSD) and/or atrial septal defect (ASD)	1st trimester	population based cohort retrospective	unexposed (general population or NOS)	Adjustment: Yes Monotherapy: SNRI only	1.26 [0.63;2.26]	11/1,351 6,272/1,062,190	6,283	1,351		ref
					Total	5 studies	1.30 [0.88;1.93]		23,888	4,918
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

1: Controls unexposed, sick; 2: Controls unexposed, sick; 3: Controls unexposed, NOS;

Sensitivity analysis

Publication bias and p-hacking diagnosis

funnel plot

Asymetry test p-value = 0.4614 (by Egger's regression)

slope=-0.2953 (0.6439); intercept=1.8174 (2.1573); t=0.8424; p=0.4614

p values plot

Sub-groups analysis using all included studies

excluded 11693, 18315, 18316