Tricyclic antidepressants updated on 07-01-2025

Neonatal disorders (as a whole)

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
R78336		 Lee (Controls exposed to SSRI), 2025 Any neonatal outcomes (preterm, low birth weight, small for gestational age, large for gestational age, low Apgar score, during pregnancy (anytime or not specified) retrospective cohort (claims database) exposed to other treatment, sick excluded Adjustment: No Monotherapy: TCA only 1.06 [0.88;1.28] C
excluded (control group) 		328/613   763/1,465 1,091 613
ref
S18410
R77737		 Lee (Controls unexposed, general pop), 2025 Any neonatal outcomes (preterm, low birth weight, small for gestational age, large for gestational age, low Apgar score, during pregnancy (anytime or not specified) retrospective cohort (claims database) unexposed (general population or NOS) Adjustment: Yes Monotherapy: TCA only 1.38 [1.18;1.63] 328/613   161,405/463,440 161,733 613
ref
S11668
R42782		 Källen, 2013 Neonatal diagnosis 2nd and/or 3rd trimester population based cohort retrospective unexposed (general population or NOS) Adjustment: Yes Monotherapy: no or not specified 1.87 [1.46;2.39] 77/394   -/- - 394
ref
Total 2 studies 1.58 [1.18;2.13] 161,733 1,007
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 1.38[1.18; 1.63]161,73361355%ROB confusion: seriousROB selection: lowROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Källen, 2013Källen, 2013 1.87[1.46; 2.39]-39445%ROB confusion: criticalROB selection: lowROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Total (2 studies) I2 = 76% 1.58[1.18; 2.13]161,7331,0070.55.01.0ROB: 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 1.58[1.18; 2.13]161,7331,00776%NALee (Controls unexposed, general pop), 2025 Källen, 2013 2 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.58[1.18; 2.13]161,7331,00776%NALee (Controls unexposed, general pop), 2025 Källen, 2013 2 Tags Adjustment   - Yes  - Yes 1.58[1.18; 2.13]161,7331,00776%NALee (Controls unexposed, general pop), 2025 Källen, 2013 2 Monotherapy   - no or not specified  - no or not specified 1.87[1.46; 2.39]-394 -NAKällen, 2013 1   - TCA only  - TCA only 1.38[1.17; 1.62]161,733613 -NALee (Controls unexposed, general pop), 2025 1 All studiesAll studies 1.58[1.18; 2.13]161,7331,00776%NALee (Controls unexposed, general pop), 2025 Källen, 2013 20.55.01.0

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) 1.58[1.18; 2.13]161,8011,00776%NALee (Controls unexposed, general pop), 2025 Källen, 2013 2 exposed to other treatment, sick controlsexposed to other treatment, sick controls 1.06[0.88; 1.28]1,091613 -NALee (Controls exposed to SSRI), 2025 10.510.01.0