Paroxetine 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.
S7470
R22253		 Anderson, 2020 Septal defects 1st trimester case control unexposed (general population or NOS) Adjustment: Yes Monotherapy: substance alone among all Antidep (SSRI, SNRI, ...) 1.57 [0.97;2.55] -/-   0/- - -
ref
S7434
R21898		 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) 1.39 [1.00;1.93] -/1,132   -/14,847 - 1,132
ref
S6006
R15400		 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, ...) 1.37 [0.96;1.95] 37/2,879   17,503/2,266,875 17,540 2,879
ref
S7350
R21498		 Wemakor, 2015 Septal defects 1st trimester case control unexposed (general population or NOS) Adjustment: Yes Monotherapy: substance alone among all Antidep (SSRI, SNRI, ...) 1.92 [1.09;3.37] 23/50   8,108/25,164 8,131 50
ref
S7228
R20757		 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 0.50 [0.07;3.54] 1/182   681/49,654 682 182
ref
S6160
R16175		 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, ...) 0.80 [0.30;2.20] 6/36   1,155/6,985 1,161 36
ref
Total 6 studies 1.42 [1.17;1.73] 27,514 4,279
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 1.57[0.97; 2.55]--17%ROB confusion: seriousROB selection: criticalROB classification: criticalROB missing: lowROB mesure: unclearROB reporting: moderate Bérard, 2017Bérard, 2017 1.39[1.00; 1.93]-1,13236%ROB confusion: seriousROB selection: moderateROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Furu, 2015Furu, 2015 1.37[0.96; 1.95]17,5402,87931%ROB confusion: criticalROB selection: lowROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: moderate Wemakor, 2015Wemakor, 2015 1.92[1.09; 3.37]8,1315012%ROB confusion: criticalROB selection: criticalROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Davis, 2007Davis, 2007 0.50[0.07; 3.54]6821821%ROB confusion: criticalROB selection: moderateROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: moderate Louik, 2007Louik, 2007 0.80[0.30; 2.20]1,161364%ROB confusion: moderateROB selection: criticalROB classification: criticalROB missing: lowROB mesure: criticalROB reporting: moderate Total (6 studies) I2 = 0% 1.42[1.17; 1.73]27,5144,2790.25.01.0ROB: 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 1.36[1.07; 1.73]18,2224,1930%NABérard, 2017 Furu, 2015 Davis, 2007 3 case control studiescase control studies 1.55[1.07; 2.25]9,2928611%NAAnderson, 2020 Wemakor, 2015 Louik, 2007 3 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.44[1.13; 1.84]27,5143,1470%NAAnderson, 2020 Furu, 2015 Wemakor, 2015 Davis, 2007 Louik, 2007 5 unexposed, sickunexposed, sick 1.39[1.00; 1.93]-1,132 -NABérard, 2017 1 Tags Adjustment   - No  - No 0.50[0.07; 3.56]682182 -NADavis, 2007 1   - Yes  - Yes 1.44[1.18; 1.75]26,8324,0970%NAAnderson, 2020 Bérard, 2017 Furu, 2015 Wemakor, 2015 Louik, 2007 5 Monotherapy   - no or not specified  - no or not specified 0.50[0.07; 3.56]682182 -NADavis, 2007 1   - substance alone among all Antidep ( ...  - substance alone among all Antidep (SSRI, SNRI, ...) 1.47[1.20; 1.80]25,6714,0610%NAAnderson, 2020 Bérard, 2017 Furu, 2015 Wemakor, 2015 4   - substance alone among the specific ...  - substance alone among the specific class of antidep (SSRI, SNRI, ...) 0.80[0.30; 2.17]1,16136 -NALouik, 2007 1 Unexposed sick   - intermediate history of illness/tre ...  - intermediate history of illness/treatment (3-12 months before pregnancy) 1.39[1.00; 1.93]-1,132 -NABérard, 2017 1 All studiesAll studies 1.42[1.17; 1.73]27,5144,2790%NAAnderson, 2020 Bérard, 2017 Furu, 2015 Wemakor, 2015 Davis, 2007 Louik, 2007 60.25.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-2.42.71.2010.000Anderson, 2020Bérard, 2017Furu, 2015Wemakor, 2015Davis, 2007Louik, 2007

Asymetry test p-value = 0.2827 (by Egger's regression)

slope=0.5614 (0.1873); intercept=-0.9462 (0.7630); t=1.2402; p=0.2827

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) 1.44[1.13; 1.84]27,5143,1470%NAAnderson, 2020 Furu, 2015 Wemakor, 2015 Davis, 2007 Louik, 2007 5 unexposed, sick controlsunexposed, sick controls 1.39[1.00; 1.93]-1,132 -NABérard, 2017 10.510.01.0

Umbrella review (other published meta-analyses)

Published MAControlPeriodTE95% CIn exposedkI2 Bérard (Bulbus cordis anomalies and anomalies ...Bérard (Bulbus cordis anomalies and anomalies of cardiac septal closure) 1.42[1.07; 1.89]0%-Wwhatever (meta-analysis)T11st trimesterstudies TTT8 Grigoriadis (Cardiac septal heart defects (st ...Grigoriadis (Cardiac septal heart defects (studies above quality threshold)) 0.97[0.47; 2.03]0%-Wwhatever (meta-analysis)Anyduring pregnancy (anytime or not specified)studies TTT3 metaPregmetaPreg 1.42[1.17; 1.73]0%4,279----Anderson, 2020 Bérard, 2017 Furu, 2015 Wemakor, 2015 Davis, 2007 Louik, 2007 60.510.01.0