Fluoxetine updated on 07-01-2025

Cardiac septal defects

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
R22211		 Anderson, 2020 Septal defects 1st trimester case control unexposed (general population or NOS) Adjustment: Yes Monotherapy: substance alone among all Antidep (SSRI, SNRI, ...) 1.19 [0.80;1.77] -/-   0/- - -
ref
S7438
R21948		 Bérard, 2017 Ventricular/atrial septal defect 1st trimester retrospective cohort (claims database) unexposed, sick Adjustment: Yes Monotherapy: substance alone among all Antidep (SSRI, SNRI, ...) Unexposed sick: intermediate history of illness/treatment (3-12 months before pregnancy) 0.55 [0.14;2.27] -/191   -/14,847 - 191
ref
S6004
R15368		 Furu, 2015 Atrial and ventricular septal defects 1st trimester population based cohort retrospective unexposed (general population or NOS) Adjustment: Yes Monotherapy: substance alone among all Antidep (SSRI, SNRI, ...) 1.45 [1.15;1.84] 74/6,250   17,503/2,266,875 17,577 6,250
ref
S7349
R21472		 Wemakor, 2015 Septal defects 1st trimester case control unexposed (general population or NOS) Adjustment: Yes Monotherapy: substance alone among all Antidep (SSRI, SNRI, ...) 1.23 [0.66;2.29] 16/43   8,115/25,171 8,131 43
ref
S6157
R16119		 Louik, 2007 Septal defects 1st trimester case control unexposed (general population or NOS) Adjustment: Yes Monotherapy: substance alone among the specific class of antidep (SSRI, SNRI, ...) 1.00 [0.50;2.20] 10/71   1,151/6,950 1,161 71
ref
Total 5 studies 1.32 [1.09;1.58] 26,869 6,555
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 1.19[0.80; 1.77]--22%ROB confusion: seriousROB selection: criticalROB classification: criticalROB missing: lowROB mesure: unclearROB reporting: moderate Bérard, 2017Bérard, 2017 0.55[0.14; 2.27]-1912%ROB confusion: seriousROB selection: moderateROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: moderate Furu, 2015Furu, 2015 1.45[1.15; 1.84]17,5776,25062%ROB confusion: criticalROB selection: moderateROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Wemakor, 2015Wemakor, 2015 1.23[0.66; 2.29]8,131439%ROB confusion: criticalROB selection: criticalROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Louik, 2007Louik, 2007 1.00[0.50; 2.20]1,161716%ROB confusion: moderateROB selection: criticalROB classification: criticalROB missing: lowROB mesure: criticalROB reporting: moderate Total (5 studies) I2 = 0% 1.32[1.09; 1.58]26,8696,5550.25.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.15[0.51; 2.59]17,5776,44145%NABérard, 2017 Furu, 2015 2 case control studiescase control studies 1.16[0.86; 1.58]9,2921140%NAAnderson, 2020 Wemakor, 2015 Louik, 2007 3 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.34[1.11; 1.61]26,8696,3640%NAAnderson, 2020 Furu, 2015 Wemakor, 2015 Louik, 2007 4 unexposed, sickunexposed, sick 0.55[0.14; 2.21]-191 -NABérard, 2017 1 Tags Adjustment   - Yes  - Yes 1.32[1.09; 1.58]26,8696,5550%NAAnderson, 2020 Bérard, 2017 Furu, 2015 Wemakor, 2015 Louik, 2007 5 Monotherapy   - substance alone among all Antidep ( ...  - substance alone among all Antidep (SSRI, SNRI, ...) 1.34[1.11; 1.62]25,7086,4840%NAAnderson, 2020 Bérard, 2017 Furu, 2015 Wemakor, 2015 4   - substance alone among the specific ...  - substance alone among the specific class of antidep (SSRI, SNRI, ...) 1.00[0.48; 2.10]1,16171 -NALouik, 2007 1 Unexposed sick   - intermediate history of illness/tre ...  - intermediate history of illness/treatment (3-12 months before pregnancy) 0.55[0.14; 2.21]-191 -NABérard, 2017 1 All studiesAll studies 1.32[1.09; 1.58]26,8696,5550%NAAnderson, 2020 Bérard, 2017 Furu, 2015 Wemakor, 2015 Louik, 2007 50.25.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-1.71.90.8530.000Anderson, 2020Bérard, 2017Furu, 2015Wemakor, 2015Louik, 2007

Asymetry test p-value = 0.0149 (by Egger's regression)

slope=0.5361 (0.0600); intercept=-1.4423 (0.2850); t=5.0610; p=0.0149

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.34[1.11; 1.61]26,8696,3640%NAAnderson, 2020 Furu, 2015 Wemakor, 2015 Louik, 2007 4 unexposed, sick controlsunexposed, sick controls 0.55[0.14; 2.21]-191 -NABérard, 2017 10.510.01.0

Umbrella review (other published meta-analyses)

Published MAControlPeriodTE95% CIn exposedkI2 Grigoriadis (Cardiac septal heart defects (st ...Grigoriadis (Cardiac septal heart defects (studies above quality threshold)) 1.18[0.65; 2.14]0%-Wwhatever (meta-analysis)Anyduring pregnancy (anytime or not specified)studies TTT2 Gao (Septal defects)Gao (Septal defects) 1.38[1.19; 1.61]0%-Wwhatever (meta-analysis)T11st trimesterstudies TTT7 metaPregmetaPreg 1.32[1.09; 1.58]0%6,555----Anderson, 2020 Bérard, 2017 Furu, 2015 Wemakor, 2015 Louik, 2007 50.510.01.0