Tricyclic antidepressants updated on 07-01-2025

Low Apgar score (< 7) (at 1 min)

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.
S18445
R78341		 Lee (Controls exposed to SSRI), 2025 1-minute Apgar score <7 during pregnancy (anytime or not specified) retrospective cohort (claims database) exposed to other treatment, sick excluded Adjustment: No Monotherapy: TCA only 1.12 [0.74;1.70] C
excluded (control group) 		34/613   73/1,465 107 613
ref
S18410
R77742		 Lee (Controls unexposed, general pop), 2025 1-minute Apgar score <7 during pregnancy (anytime or not specified) retrospective cohort (claims database) unexposed (general population or NOS) Adjustment: Yes Monotherapy: TCA only 1.33 [0.93;1.89] 34/613   14,883/463,440 14,917 613
ref
Total 1 studies 1.33 [0.93;1.90] 14,917 613
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 Lee (Controls unexposed, general pop), 2025Lee, 2025 1 1.33[0.93; 1.89]14,9176130%ROB confusion: moderateROB selection: lowROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: moderate0.55.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Controls unexposed, general pop;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.33[0.93; 1.90]14,917613 -NALee (Controls unexposed, general pop), 2025 1 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.33[0.93; 1.90]14,917613 -NALee (Controls unexposed, general pop), 2025 1 Tags Adjustment   - Yes  - Yes 1.33[0.93; 1.90]14,917613 -NALee (Controls unexposed, general pop), 2025 1 Monotherapy   - TCA only  - TCA only 1.33[0.93; 1.90]14,917613 -NALee (Controls unexposed, general pop), 2025 1 All studiesAll studies 1.33[0.93; 1.90]14,917613 -NALee (Controls unexposed, general pop), 2025 10.55.01.0

Publication bias and p-hacking diagnosis

funnel plot

Funnel plot not drawn. Less than 3 points.

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

not enought points

p values plot

Funnel plot not drawn. Less than 3 points.

Sub-groups analysis using all included studies

excluded 18445

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.33[0.93; 1.90]14,917613 -NALee (Controls unexposed, general pop), 2025 1 exposed to other treatment, sick controlsexposed to other treatment, sick controls 1.12[0.74; 1.70]107613 -NALee (Controls exposed to SSRI), 2025 10.510.01.0