Fluoxetine updated on 07-01-2025

Atrial 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.
S7469
R22214		 Anderson, 2020 Atrial septal defect (ASD) – secundum type 1st trimester case control unexposed (general population or NOS) Adjustment: Yes Monotherapy: substance alone among all Antidep (SSRI, SNRI, ...) 1.11 [0.65;1.88] -/-   0/- - -
ref
S7349
R21464		 Wemakor, 2015 Atrial septal defect 1st trimester case control unexposed (general population or NOS) Adjustment: Yes Monotherapy: substance alone among all Antidep (SSRI, SNRI, ...) 1.67 [0.68;4.11] 6/33   2,685/19,741 2,691 33
ref
S6016
R15531		 Jimenez-Solem (Controls unexposed, NOS), 2012 Atrial septal defects 1st trimester population based cohort retrospective unexposed (general population or NOS) excluded Adjustment: Yes Monotherapy: substance alone among the specific class of antidep (SSRI, SNRI, ...) 2.53 [1.20;5.32]
excluded (control group) 		7/928   2,490/843,797 2,497 928
ref
S6021
R15613		 Jimenez-Solem (Controls unexposed, sick), 2012 Atrial septal defects 1st trimester population based cohort retrospective unexposed, sick Adjustment: No Monotherapy: substance alone among the specific class of antidep (SSRI, SNRI, ...) Unexposed sick: intermediate history of illness/treatment (3-12 months before pregnancy) 1.01 [0.34;3.03] C 7/928   6/806 13 928
ref
S6242
R16490		 Malm, 2011 Atrial septal defects 1st trimester population based cohort retrospective unexposed (general population or NOS) Adjustment: Yes Monotherapy: no or not specified 1.52 [0.71;3.24] 7/1,818   1,279/628,607 1,286 1,818
ref
Total 4 studies 1.27 [0.88;1.83] 3,990 2,779
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 Anderson, 2020Anderson, 2020 1.11[0.65; 1.88]--48%ROB confusion: seriousROB selection: criticalROB classification: criticalROB missing: lowROB mesure: unclearROB reporting: moderate Wemakor, 2015Wemakor, 2015 1.67[0.68; 4.11]2,6913317%ROB confusion: criticalROB selection: criticalROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Jimenez-Solem (Controls unexposed, sick), 2012Jimenez-Solem, 2012 1 1.01[0.34; 3.03]1392811%ROB confusion: criticalROB selection: moderateROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: critical Malm, 2011Malm, 2011 1.52[0.71; 3.24]1,2861,81824%ROB confusion: criticalROB selection: lowROB classification: criticalROB missing: lowROB mesure: criticalROB reporting: moderate Total (4 studies) I2 = 0% 1.27[0.88; 1.83]3,9902,7790.55.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Controls unexposed, sick;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.33[0.71; 2.49]1,2992,7460%NAJimenez-Solem (Controls unexposed, sick), 2012 Malm, 2011 2 case control studiescase control studies 1.23[0.78; 1.95]2,691330%NAAnderson, 2020 Wemakor, 2015 2 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.30[0.88; 1.93]3,9771,8510%NAAnderson, 2020 Wemakor, 2015 Malm, 2011 3 unexposed, sickunexposed, sick 1.01[0.34; 3.03]13928 -NAJimenez-Solem (Controls unexposed, sick), 2012 1 Tags Adjustment   - No  - No 1.01[0.34; 3.03]13928 -NAJimenez-Solem (Controls unexposed, sick), 2012 1   - Yes  - Yes 1.30[0.88; 1.93]3,9771,8510%NAAnderson, 2020 Wemakor, 2015 Malm, 2011 3 Monotherapy   - no or not specified  - no or not specified 1.52[0.71; 3.25]1,2861,818 -NAMalm, 2011 1   - substance alone among all Antidep ( ...  - substance alone among all Antidep (SSRI, SNRI, ...) 1.23[0.78; 1.95]2,691330%NAAnderson, 2020 Wemakor, 2015 2   - substance alone among the specific ...  - substance alone among the specific class of antidep (SSRI, SNRI, ...) 1.01[0.34; 3.03]13928 -NAJimenez-Solem (Controls unexposed, sick), 2012 1 Unexposed sick   - intermediate history of illness/tre ...  - intermediate history of illness/treatment (3-12 months before pregnancy) 1.01[0.34; 3.03]13928 -NAJimenez-Solem (Controls unexposed, sick), 2012 1 All studiesAll studies 1.27[0.88; 1.83]3,9902,7790%NAAnderson, 2020 Wemakor, 2015 Jimenez-Solem (Controls unexposed, sick), 2012 Malm, 2011 40.55.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-1.31.60.6700.000Anderson, 2020Wemakor, 2015Jimenez-Solem (Controls unexposed, sick), 2012Malm, 2011

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 6016

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.52[1.06; 2.17]6,4742,7796%NAAnderson, 2020 Wemakor, 2015 Jimenez-Solem (Controls unexposed, NOS), 2012 Malm, 2011 4 unexposed, sick controlsunexposed, sick controls 1.01[0.34; 3.03]13928 -NAJimenez-Solem (Controls unexposed, sick), 2012 10.510.01.0