Tricyclic antidepressants updated on 07-01-2025

Cardiac septal defects

id	Study   Auto Chan (Controls exposed to SSRIs), 2024Chan (Controls unexposed, general pop), 2024Chan (Controls unexposed, sick), 2024Bérard (Controls unexposed, sick), 2017Ban (Controls unexposed, disease free), 2014Källen, 2013Davis, 2007	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.
S18161 R76385	Chan (Controls exposed to SSRIs), 2024	Cardiac septal defect	1st trimester	retrospective cohort (claims database)	exposed to other treatment, sick excluded	Adjustment: No Monotherapy: TCA only	1.43 [0.66;3.06] C excluded (control group)	10/322   21/956	31	322		ref
S18156 R76339	Chan (Controls unexposed, general pop), 2024	Cardiac septal defect	1st trimester	retrospective cohort (claims database)	unexposed (general population or NOS) excluded	Adjustment: Yes Monotherapy: TCA only	3.10 [1.50;6.40] excluded (control group)	10/322   6,299/462,377	6,309	322		ref
S18157 R76350	Chan (Controls unexposed, sick), 2024	Cardiac septal defect	1st trimester	retrospective cohort (claims database)	unexposed, sick	Adjustment: Yes Monotherapy: TCA only Unexposed sick: old history of illness/treatment (> 12 months before pregnancy) or not specified	0.66 [0.16;2.72]	2/181   74/4,413	76	181		ref
S11052 R40988	Bérard (Controls unexposed, sick), 2017	Ventricular/atrial septal defect	1st trimester	retrospective cohort (claims database)	unexposed, sick	Adjustment: Yes Monotherapy: TCA only Unexposed sick: intermediate history of illness/treatment (3-12 months before pregnancy)	1.10 [0.54;2.24]	-/382   -/14,847	-	382		ref
S10938 R40733	Ban (Controls unexposed, disease free), 2014	Septal defects	1st trimester	retrospective cohort (claims database)	unexposed, disease free	Adjustment: Yes Monotherapy: TCA only	0.98 [0.55;1.73]	-/2,428   -/325,294	-	2,428		ref
S11668 R42773	Källen, 2013	Septum defects	early pregnancy	population based cohort retrospective	unexposed (general population or NOS)	Adjustment: Yes Monotherapy: no or not specified	1.66 [1.17;2.35]	31/2,139   -/-	-	2,139		ref
S10930 R40600	Davis, 2007	Bulbus cordis anomalies and anomalies of cardiac septal closure	1st trimester	retrospective cohort (claims database)	unexposed (general population or NOS)	Adjustment: No Monotherapy: no or not specified	0.92 [0.23;3.70]	2/167   680/49,669	682	167		ref
					Total	5 studies	1.31 [1.00;1.73]		758	5,297
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 18161, 18156