Citalopram

Table   Graphic  
individual studies
OutcomeTE95% CIn casesn exposedkPub. bias Congenital malformations All congenital malformations (majors, minors, majors and minors, or unspecified) Heikkinen, 2002 Sivojelezova (Control unexposed, NOS), 2005 Oberlander a, 2008 Einarson, 2009 Reis (Controls unexposed, NOS), 2010 Colvin, 2011 Nordeng - Citalopram/Escitalopram (Controls unexposed, sick), 2012 Ban (Controls unexposed, sick), 2014 Furu, 2015 Ozturk, 2016 Bérard, 2017 Anderson, 2020 Chan (Controls unexposed, pop general), 2024 131.19[1.10; 1.28]133,68319,314low Major congenital malformations Sivojelezova (Control unexposed, NOS), 2005 Oberlander a, 2008 Einarson, 2009 Reis (Controls unexposed, NOS), 2010 Colvin, 2011 Nordeng - Citalopram/Escitalopram (Controls unexposed, sick), 2012 Ban (Controls unexposed, sick), 2014 Furu, 2015 Ozturk, 2016 Bérard, 2017 Anderson, 2020 Chan (Controls unexposed, pop general), 2024 121.18[1.09; 1.27]132,89819,304low Congenital heart defects Louik, 2007 Oberlander a, 2008 Merlob, 2009 Reis (Controls unexposed, NOS), 2010 Colvin, 2011 Nordeng - Citalopram/Escitalopram (Controls unexposed, sick), 2012 Ban (Controls unexposed, sick), 2014 Wemakor, 2015 Furu, 2015 Bérard, 2017 Anderson, 2020 Chan (Controls unexposed, pop general), 2024 121.20[1.00; 1.44]54,04018,951low Limb defects Colvin, 2011 Malm, 2011 Jimenez-Solem (Controls unexposed, sick), 2012 De Jonge, 2013 Ban (Controls unexposed, sick), 2014 Bérard, 2017 Anderson, 2020 71.12[0.78; 1.59]1,3457,745not evaluable Digestive system anomalies Colvin, 2011 Malm, 2011 Jimenez-Solem (Controls unexposed, sick), 2012 Ban (Controls unexposed, disease free), 2014 Wemakor, 2015 Bérard, 2017 61.24[0.84; 1.82]3,5907,732not evaluable Craniosynostosis Louik, 2007 Malm, 2011 Wemakor, 2015 Furu, 2015 Bérard, 2017 Anderson, 2020 61.85[1.06; 3.25]1,64014,612not evaluable Genital anomalies Jimenez-Solem (Controls unexposed, sick), 2012 De Jonge, 2013 Ban (Controls unexposed, sick), 2014 Bérard, 2017 40.89[0.52; 1.51]3824,171not evaluable Hypospadias Louik, 2007 Reis (Controls unexposed, NOS), 2010 Furu, 2015 Wemakor, 2015 Anderson, 2020 51.45[1.08; 1.95]8,12415,191not evaluable Nervous system anomalies Colvin, 2011 Malm, 2011 Jimenez-Solem (Controls unexposed, NOS), 2012 De Jonge, 2013 Ban (Controls unexposed, disease free), 2014 Bérard, 2017 61.20[0.81; 1.78]9447,745not evaluable Atrial septal defect Malm, 2011 Jimenez-Solem (Controls unexposed, sick), 2012 Wemakor, 2015 Anderson, 2020 41.07[0.69; 1.66]3,9944,429not evaluable Cardiac septal defects Louik, 2007 Furu, 2015 Wemakor, 2015 Bérard, 2017 Anderson, 2020 51.15[0.97; 1.36]26,91411,823not evaluable Cleft lip with or without cleft palate Louik, 2007 Malm, 2011 Anderson, 2020 31.27[0.59; 2.75]7042,818not evaluable Cleft palate Louik, 2007 Malm, 2011 Anderson, 2020 31.12[0.61; 2.06]3772,815not evaluable Oro-facial clefts Jimenez-Solem (Controls unexposed, NOS), 2012 De Jonge, 2013 Ban (Controls unexposed, disease free), 2014 Anderson, 2020 41.24[0.79; 1.94]7233,587not evaluable Respiratory system anomalies Colvin, 2011 Malm, 2011 Jimenez-Solem (Controls unexposed, NOS), 2012 Ban (Controls unexposed, disease free), 2014 Wemakor, 2015 50.88[0.42; 1.82]1,2637,148not evaluable Urinary malformations Louik, 2007 Jimenez-Solem (Controls unexposed, NOS), 2012 Ban (Controls unexposed, disease free), 2014 Bérard, 2017 41.66[0.88; 3.13]3,7924,153not evaluable Ventricular septal defect Malm, 2011 Jimenez-Solem (Controls unexposed, sick), 2012 Wemakor, 2015 Anderson, 2020 40.87[0.51; 1.49]11,6844,430not evaluable Ano-rectal atresia and stenosis Louik, 2007 Furu, 2015 Wemakor, 2015 Anderson, 2020 41.61[0.91; 2.85]1,39311,230not evaluable Club foot / Talipes equinovarus Louik, 2007 Yazdy, 2014 Furu, 2015 Wemakor, 2015 41.59[1.12; 2.24]6,22811,248not evaluable Eye defects Colvin, 2011 Jimenez-Solem (Controls unexposed, NOS), 2012 Ban (Controls unexposed, disease free), 2014 Wemakor, 2015 41.98[1.02; 3.83]1,1974,349not evaluable Neural Tube Defects Louik, 2007 Malm, 2011 Wemakor, 2015 Anderson, 2020 41.33[0.63; 2.83]1,6422,836not evaluable Abdominal wall defects Jimenez-Solem (Controls unexposed, NOS), 2012 Ban (Controls unexposed, disease free), 2014 21.98[0.39; 9.91]693,552not evaluable Atrioventricular septal defect Furu, 2015 Wemakor, 2015 Anderson, 2020 31.65[0.86; 3.16]1,36911,213not evaluable Chromosomal abnormalities Colvin, 2011 Jimenez-Solem (Controls unexposed, NOS), 2012 Ban (Controls unexposed, disease free), 2014 30.71[0.26; 1.88]7494,327not evaluable Diaphragmatic hernia Louik, 2007 Anderson, 2020 21.97[0.86; 4.51]19215not evaluable Ear, face and neck anomalies Colvin, 2011 Ban (Controls unexposed, disease free), 2014 Wemakor, 2015 31.77[0.73; 4.29]1,0442,741not evaluable Limb reduction defects (LRD) Louik, 2007 Furu, 2015 Wemakor, 2015 31.28[0.62; 2.64]2,01411,229not evaluable Coarctation of aorta Wemakor, 2015 Anderson, 2020 21.19[0.49; 2.89]57020not evaluable Omphalocele Louik, 2007 11.58[0.09; 26.64]12715not evaluable Pulmonary valve stenosis Wemakor, 2015 Anderson, 2020 21.87[0.97; 3.59]77222not evaluable Spina bifida Anderson, 2020 10.78[0.24; 2.54]--not evaluable Tetralogy of Fallot Wemakor, 2015 Anderson, 2020 22.13[0.69; 6.52]42822not evaluable Transposition of the great vessels Malm, 2011 Wemakor, 2015 20.76[0.15; 3.80]8542,819not evaluable Anotia Anderson, 2020 12.68[0.95; 7.58]--not evaluable Aortic valve atresia/stenosis 0----- Congenital hydronephrosis 0----- Ebstein's anomaly Wemakor, 2015 112.36[1.61; 95.02]9321not evaluable Encephalocele 0----- Eye, ear, face and neck malformations Bérard, 2017 11.13[0.41; 3.10]-584not evaluable Gastroschisis Given, 2017 13.11[1.25; 7.74]-136not evaluable Hip dislocation and/or dysplasia 0----- Hirschsprung's disease 0----- Hydrocephaly 0----- Hypoplastic left heart (HLH/HLHS) Wemakor, 2015 12.15[0.29; 16.05]39821not evaluable Microcephaly / Small head circumference for gestational age Kivistö, 2016 11.30[0.78; 2.16]1,700-not evaluable Multicystic renal dysplasia Wemakor, 2015 11.40[0.18; 10.87]61821not evaluable Oesophageal atresia with or without tracheo-oesophageal fistula Anderson, 2020 11.82[0.71; 4.66]--not evaluable Patent ductus arterious 0----- Polydactyly 0----- Pulmonary valve atresia 0----- Severe congenital heart defect Wemakor, 2015 11.85[0.73; 4.67]2,93526not evaluable Syndactyly 0----- Growth parameters and prematurity Preterm (< 37 weeks) Sivojelezova (Control unexposed, NOS), 2005 Colvin, 2011 Kivistö, 2016 Ozturk, 2016 Marks (Controls exposed to Bupropion), 2021 Martin, 2024 Lee (Controls unexposed, general pop), 2025 71.19[1.09; 1.30]159,55022,802not evaluable Low birth weight (< 2500g) Colvin, 2011 Kivistö, 2016 Lee (Controls unexposed, general pop), 2025 31.58[1.34; 1.87]39,7941,453not evaluable Small for gestational age (weight) Kivistö, 2016 Martin, 2024 Lee (Controls unexposed, general pop), 2025 31.10[1.05; 1.15]240,38917,895not evaluable Large for gestational age (weight) Kivistö, 2016 Lee (Controls unexposed, general pop), 2025 21.09[0.71; 1.67]11,929296not evaluable Large for gestational age (length) Kivistö, 2016 10.82[0.44; 1.53]1,472-not evaluable Large head circumference for gestational age Kivistö, 2016 10.51[0.28; 0.93]2,560-not evaluable Small for gestational age (length) Kivistö, 2016 11.06[0.63; 1.78]1,838-not evaluable Maternal consequences Caesarean Heikkinen, 2002 Colvin, 2011 Kivistö, 2016 Lee (Controls unexposed, general pop), 2025 41.02[0.89; 1.17]146,0481,443not evaluable Postpartum hemorrhage Colvin, 2011 Palmsten b, 2013 Lee (Controls unexposed, general pop), 2025 31.27[1.08; 1.49]30,2762,108not evaluable Assisted deliveries (forceps, vacuum, ...) Kivistö, 2016 Lee (Controls unexposed, general pop), 2025 20.82[0.49; 1.36]47,641296not evaluable Preeclampsia De Vera, 2012 Palmsten (Controls unexposed, sick), 2013 21.01[0.83; 1.23]4,5221,680not evaluable Maternal consequences (as a whole) Lee (Controls unexposed, general pop), 2025 11.01[0.62; 1.64]311,15181not evaluable Gestational diabetes Dandjinou, 2019 11.11[0.95; 1.29]20,9052,243not evaluable Neonatal disorders Low Apgar score (< 7) (at 5 min) Colvin, 2011 Kivistö, 2016 Marks (Controls exposed to Bupropion), 2021 Martin, 2024 Lee (Controls unexposed, general pop), 2025 51.79[1.28; 2.48]35,26917,334not evaluable Neonatal medical care Sivojelezova (Control unexposed, NOS), 2005 Kivistö, 2016 Marks (Controls exposed to Bupropion), 2021 Cornet, 2024 Lee (Controls unexposed, general pop), 2025 52.02[1.53; 2.66]23,2731,569not evaluable Withdrawal syndrome / Neonatal abstinence syndrome / Poor neonatal adaptation Levinson-Castiel, 2006 Dave, 2019 Marks (Controls unexposed, sick), 2021 35.02[2.41; 10.45]66011,215not evaluable Low Apgar score (< 7) (at 1 min) Kivistö, 2016 Lee (Controls unexposed, general pop), 2025 22.59[1.82; 3.69]16,334296not evaluable Neonatal death (< 28 days of life) Lee (Controls unexposed, general pop), 2025 14.58[0.28; 73.96]62781not evaluable Neonatal disorders (as a whole) Sivojelezova (Control unexposed, NOS), 2005 Lee (Controls unexposed, general pop), 2025 21.95[1.16; 3.29]161,510144not evaluable Persistent pulmonary hypertension Kieler, 2012 Marks (Controls exposed to Bupropion), 2021 22.38[1.30; 4.34]1,9483,679not evaluable Fetal distress Colvin, 2011 11.40[1.20; 1.63]12,8781,136not evaluable Jaundice / Icterus Marks (Controls exposed to Bupropion), 2021 10.91[0.61; 1.34]118385not evaluable Neonatal tachypnea Marks (Controls exposed to Bupropion), 2021 11.51[0.95; 2.39]83385not evaluable Long term consequences Child/Infant death (> 28 days of life) Colvin, 2012 Lee (Controls unexposed, general pop), 2025 23.53[0.20; 63.43]1,20281not evaluable Intrauterine deaths Early intrauterine deaths (< 22 weeks) / Spontaneous abortions Yaris, 2005 Sivojelezova (Control unexposed, NOS), 2005 Nakhai-Pour, 2010 Andersen, 2014 Ozturk, 2016 Kitchin, 2022 61.29[1.21; 1.37]162,44610,152not evaluable Late intrauterine deaths (> 22 weeks) / Stillbirths Sivojelezova (Control unexposed, NOS), 2005 Colvin, 2011 21.00[0.49; 2.04]6221,289not evaluable Ectopic pregnancy Colvin, 2011 11.00[0.56; 1.78]1,4951,012not evaluable Intrauterine deaths (as a whole or unspecified) Colvin, 2011 Sjaarda (Citalopram/Escitalopram), 2020 21.17[0.92; 1.48]24,7021,049not evaluable Therapeutic terminations of pregnancy Sivojelezova (Control unexposed, NOS), 2005 15.08[0.24; 106.79]2132not evaluable Elective/induced termination of pregnancy Ozturk, 2016 15.99[0.23; 153.53]142not evaluable Perinatal death Kivistö, 2016 13.25[1.01; 10.46]121215not evaluable Neuro-developmental disorders ASD (Autism spectrum disorder): Diagnosis Bérard, 2016 Brown, 2017 Viktorin (citalopram or escitalopram) (Controls unexposed, sick), 2017 Rai (Controls unexposed, sick), 2017 Suarez (Controls unexposed, discontinuers), 2022 Heuvelman, 2023 61.55[1.31; 1.84]1,55820,541not evaluable ASD (Autism spectrum disorder): Diagnosis/Risk Bérard, 2016 Brown, 2017 Viktorin (citalopram or escitalopram) (Controls unexposed, sick), 2017 Rai (Controls unexposed, sick), 2017 Suarez (Controls unexposed, discontinuers), 2022 Heuvelman, 2023 61.55[1.31; 1.84]1,55820,541not evaluable ADHD (Attention deficit hyperactivity disorder): Diagnosis Suarez (Controls unexposed, discontinuers), 2022 Olstad - (Es)citalopram (Controls unexposed, sick), 2023 Heuvelman, 2023 31.03[0.85; 1.25]59718,723not evaluable ADHD (Attention deficit hyperactivity disorder): Diagnosis/Risk Suarez (Controls unexposed, discontinuers), 2022 Olstad - (Es)citalopram (Controls unexposed, sick), 2023 Heuvelman, 2023 31.03[0.85; 1.25]59718,723not evaluable Cognitive developmental disorders/delay (3-6 years old) Suarez (Controls unexposed, discontinuers), 2022 11.26[0.41; 3.85]39,050not evaluable ADHD (Attention deficit hyperactivity disorder): Risk Olstad - (Es)citalopram (Controls unexposed, sick), 2023 10.59[0.37; 0.95]-128not evaluable Language disorders/delay Suarez (Controls unexposed, discontinuers), 2022 11.10[0.90; 1.34]67113,797not evaluable Learning disorders Suarez (Controls unexposed, discontinuers), 2022 11.64[0.65; 4.11]129,050not evaluable Neuro-developmental disorders (as a whole) Suarez (Controls unexposed, discontinuers), 2022 11.06[0.91; 1.23]1,37513,797not evaluable Psychomotor developmental disorders/delay Suarez (Controls unexposed, discontinuers), 2022 11.39[0.82; 2.36]10413,797not evaluable Severe cognitive developmental delay (Mental retardation) (3-6 years old) Suarez (Controls unexposed, discontinuers), 2022 11.26[0.41; 3.85]39,050not evaluable Cognitive developmental disorders/delay (> 6 years old) Heuvelman, 2023 10.59[0.29; 1.20]-4,620not evaluable Severe cognitive developmental delay (Mental retardation) (> 6 years old) Heuvelman, 2023 10.59[0.29; 1.20]-4,620not evaluable0.0100.01.0

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