Tricyclic antidepressants 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.
S18161
R76386		 Chan (Controls exposed to SSRIs), 2024 Ventral septal defect (VSD) 1st trimester retrospective cohort (claims database) exposed to other treatment, sick excluded Adjustment: No Monotherapy: TCA only 0.89 [0.24;3.25] C
excluded (control group) 		3/322   10/956 13 322
ref
S18156
R76340		 Chan (Controls unexposed, general pop), 2024 Ventral septal defect (VSD) 1st trimester retrospective cohort (claims database) unexposed (general population or NOS) excluded Adjustment: Yes Monotherapy: TCA only 1.67 [0.54;5.22]
excluded (control group) 		3/322   2,586/462,377 2,589 322
ref
S18157
R76351		 Chan (Controls unexposed, sick), 2024 Ventral septal defect (VSD) 1st trimester retrospective cohort (claims database) unexposed, sick Adjustment: No Monotherapy: TCA only Unexposed sick: old history of illness/treatment (> 12 months before pregnancy) or not specified 0.37 [0.02;6.12] C 0/181   32/4,413 32 181
ref
S10938
R40735		 Ban (Controls unexposed, disease free), 2014 Ventricular septal defect 1st trimester retrospective cohort (claims database) unexposed, disease free Adjustment: Yes Monotherapy: TCA only 0.93 [0.46;1.87] -/2,428   -/325,294 - 2,428
ref
S10941
R40762		 Huybrechts (Controls unexposed, NOS), 2014 Ventricular Septal Defect 1st trimester cohort unexposed (general population or NOS) excluded Adjustment: No Monotherapy: no or not specified 1.11 [0.74;1.66]
excluded (control group) 		24/5,954   3,212/885,115 3,236 5,954
ref
S10942
R40766		 Huybrechts (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 0.85 [0.50;1.46] 15/3,304   751/180,564 766 3,304
ref
S11322
R41703		 Louik, 2014 Ventricular septal defect 1st trimester case control unexposed (general population or NOS) Adjustment: Yes Monotherapy: no or not specified 0.80 [0.40;1.80] 8/40   2,696/11,275 2,704 40
ref
Total 4 studies 0.85 [0.59;1.22] 3,502 5,953
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 0.37[0.02; 6.12]321812%ROB confusion: criticalROB selection: moderateROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Ban (Controls unexposed, disease free), 2014Ban, 2014 2 0.93[0.46; 1.87]-2,42827%ROB confusion: seriousROB selection: moderateROB classification: criticalROB missing: lowROB mesure: criticalROB reporting: moderate Huybrechts (Controls unexposed, sick), 2014Huybrechts, 2014 3 0.85[0.50; 1.46]7663,30447%ROB confusion: moderateROB selection: lowROB classification: moderateROB missing: moderateROB mesure: moderateROB reporting: moderate Louik, 2014Louik, 2014 0.80[0.40; 1.80]2,7044024%ROB confusion: moderateROB selection: criticalROB classification: criticalROB missing: lowROB mesure: criticalROB reporting: moderate Total (4 studies) I2 = 0% 0.85[0.59; 1.22]3,5025,9530.22.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Controls unexposed, sick; 2: Controls unexposed, disease free; 3: Controls unexposed, sick;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 0.86[0.57; 1.31]7985,9130%NAChan (Controls unexposed, sick), 2024 Ban (Controls unexposed, disease free), 2014 Huybrechts (Controls unexposed, sick), 2014 3 case control studiescase control studies 0.80[0.38; 1.70]2,70440 -NALouik, 2014 1 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 0.87[0.52; 1.45]2,7042,4680%NABan (Controls unexposed, disease free), 2014 Louik, 2014 2 unexposed, sickunexposed, sick 0.83[0.49; 1.40]7983,4850%NAChan (Controls unexposed, sick), 2024 Huybrechts (Controls unexposed, sick), 2014 2 Tags Adjustment   - No  - No 0.37[0.02; 6.12]32181 -NAChan (Controls unexposed, sick), 2024 1   - Yes  - Yes 0.86[0.59; 1.24]3,4705,7720%NABan (Controls unexposed, disease free), 2014 Huybrechts (Controls unexposed, sick), 2014 Louik, 2014 3 Monotherapy   - no or not specified  - no or not specified 0.83[0.54; 1.29]3,4703,3440%NAHuybrechts (Controls unexposed, sick), 2014 Louik, 2014 2   - TCA only  - TCA only 0.88[0.45; 1.74]322,6090%NAChan (Controls unexposed, sick), 2024 Ban (Controls unexposed, disease free), 2014 2 Unexposed sick   - old history of illness/treatment (> ...  - old history of illness/treatment (> 12 months before pregnancy) or not specified 0.83[0.49; 1.40]7983,4850%NAChan (Controls unexposed, sick), 2024 Huybrechts (Controls unexposed, sick), 2014 2 All studiesAll studies 0.85[0.59; 1.22]3,5025,9530%NAChan (Controls unexposed, sick), 2024 Ban (Controls unexposed, disease free), 2014 Huybrechts (Controls unexposed, sick), 2014 Louik, 2014 40.110.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-3.43.21.7120.000Chan (Controls unexposed, sick), 2024Ban (Controls unexposed, disease free), 2014Huybrechts (Controls unexposed, sick), 2014Louik, 2014

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

not enought points

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded 10941, 18161, 18156

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.05[0.77; 1.42]8,5298,7440%NAChan (Controls unexposed, general pop), 2024 Ban (Controls unexposed, disease free), 2014 Huybrechts (Controls unexposed, NOS), 2014 Louik, 2014 4 unexposed, sick controlsunexposed, sick controls 0.83[0.49; 1.40]7983,4850%NAChan (Controls unexposed, sick), 2024 Huybrechts (Controls unexposed, sick), 2014 2 exposed to other treatment, sick controlsexposed to other treatment, sick controls 0.89[0.24; 3.25]13322 -NAChan (Controls exposed to SSRIs), 2024 10.510.01.0