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

Elective/induced termination of pregnancy

id	Study   Auto Ankarfeldt b - Duloxetine (Controls unexposed, NOS), 2021Ankarfeldt b - Duloxetine (Controls unexposed, sick), 2021Richardson - Venlafaxine, 2019Ozturk - Venlafaxine, 2016Te Winkel - Venlafaxine, 2016Kieler - Venlafaxine, 2015	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.
S11686 R42971	Ankarfeldt b - Duloxetine (Controls unexposed, NOS), 2021	Elective abortions (observation time was throughout the pregnancy)	during pregnancy (anytime or not specified)	population based cohort retrospective	unexposed (general population or NOS) excluded	Adjustment: Yes Monotherapy: no or not specified	1.45 [1.31;1.60] excluded (control group)	401/1,197   148,449/987,200	148,850	1,197		ref
S11687 R42973	Ankarfeldt b - Duloxetine (Controls unexposed, sick), 2021	Elective abortions (observation time was throughout the pregnancy)	during pregnancy (anytime or not specified)	population based cohort retrospective	unexposed, sick	Adjustment: Yes Monotherapy: no or not specified Unexposed sick: intermediate history of illness/treatment (3-12 months before pregnancy)	1.41 [1.21;1.64]	401/1,197   318/1,376	719	1,197		ref
S11774 R43307	Richardson - Venlafaxine, 2019	Elective termination of pregnancy	at least 1st trimester	prospective cohort	unexposed (general population or NOS)	Adjustment: No Matched Monotherapy: no or not specified	1.02 [0.60;1.68]	21/281   103/1,405	124	281		ref
S11791 R43385	Ozturk - Venlafaxine, 2016	Elective termination of pregnancy	at least 1st trimester	prospective cohort	unexposed (general population or NOS)	Adjustment: No Monotherapy: no or not specified	3.39 [0.68;16.78] C	2/13   14/275	16	13		ref
S11776 R43330	Te Winkel - Venlafaxine, 2016	Elective terminations of pregnancy (ETOPs)	during pregnancy (anytime or not specified)	prospective cohort	unexposed (general population or NOS)	Adjustment: No Monotherapy: no or not specified	2.36 [1.46;3.82] C	57/732   25/724	82	732		ref
S11691 R42989	Kieler - Venlafaxine, 2015	Elective termination of pregnancy (at 12–23 weeks of gestation)	during pregnancy (anytime or not specified)	nested case control	unexposed (general population or NOS)	Adjustment: Yes Matched Monotherapy: SNRI only	3.00 [2.10;4.30]	-/-   14,911/-	-	-		ref
					Total	5 studies	1.86 [1.21;2.86]		941	2,223
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 11686