Selective Serotonin Reuptake Inhibitor (SSRI) updated on 07-01-2025

Neonatal infections

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.
S18258
R76648		 Cornet - SSRIs, 2024 Culture-proven neonatal sepsis late pregnancy retrospective cohort (claims database) unexposed (general population or NOS) Adjustment: Yes Monotherapy: no or not specified 1.44 [0.50;4.11] 3/7,573   70/272,517 73 7,573
ref
S5461
R24134		 Levy, 2020 Sepsis throughout pregnancy retrospective cohort unexposed (general population or NOS) Adjustment: No Matched Monotherapy: no or not specified 3.04 [0.12;75.67] C 1/82   0/82 1 82
ref
S5430
R21363		 Norby, 2016 Neonatal verified infections during pregnancy (anytime or not specified) population based cohort retrospective unexposed (general population or NOS) Adjustment: Yes Monotherapy: no or not specified 1.20 [1.00;1.60] 91/17,736   2,539/718,533 2,630 17,736
ref
S12948
R49138		 Engelstad (Controls unexposed, sick), 2014 Presumed Sepsis during pregnancy (anytime or not specified) retrospective cohort unexposed, sick Adjustment: No Monotherapy: SSRI only 0.60 [0.14;2.57] C 3/126   5/128 8 126
ref
S5405
R16051		 Wen, 2006 Neonatal sepsis 3 months (or more) before pregnancy or during pregnancy excluded retrospective cohort (claims database) unexposed (general population or NOS) Adjustment: Yes Matched Monotherapy: no or not specified 1.41 [0.65;3.06]
excluded (exposition period) 		10/972   23/3,878 33 972
ref
Total 4 studies 1.20 [0.95;1.50] 2,712 25,517
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 Cornet - SSRIs, 2024Cornet - SSRIs, 2024 1.44[0.50; 4.11]737,5735%ROB confusion: moderateROB selection: lowROB classification: criticalROB missing: unclearROB mesure: moderateROB reporting: moderate Levy, 2020Levy, 2020 3.04[0.12; 75.67]1820%ROB confusion: criticalROB selection: criticalROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Norby, 2016Norby, 2016 1.20[1.00; 1.60]2,63017,73692%ROB confusion: seriousROB selection: lowROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Engelstad (Controls unexposed, sick), 2014Engelstad, 2014 1 0.60[0.14; 2.57]81262%ROB confusion: criticalROB selection: criticalROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Total (4 studies) I2 = 0% 1.20[0.95; 1.50]2,71225,5170.210.01.0ROB: 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 1.20[0.95; 1.50]2,71225,5170%NACornet - SSRIs, 2024 Levy, 2020 Norby, 2016 Engelstad (Controls unexposed, sick), 2014 4 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.22[0.97; 1.53]2,70425,3910%NACornet - SSRIs, 2024 Levy, 2020 Norby, 2016 3 unexposed, sickunexposed, sick 0.60[0.14; 2.57]8126 -NAEngelstad (Controls unexposed, sick), 2014 1 Tags Adjustment   - No  - No 0.79[0.21; 2.97]92080%NALevy, 2020 Engelstad (Controls unexposed, sick), 2014 2   - Yes  - Yes 1.21[0.96; 1.52]2,70325,3090%NACornet - SSRIs, 2024 Norby, 2016 2 MatchedMatched 3.04[0.12; 75.67]182 -NALevy, 2020 1 Monotherapy   - no or not specified  - no or not specified 1.22[0.97; 1.53]2,70425,3910%NACornet - SSRIs, 2024 Levy, 2020 Norby, 2016 3   - SSRI only  - SSRI only 0.60[0.14; 2.57]8126 -NAEngelstad (Controls unexposed, sick), 2014 1 All studiesAll studies 1.20[0.95; 1.50]2,71225,5170%NACornet - SSRIs, 2024 Levy, 2020 Norby, 2016 Engelstad (Controls unexposed, sick), 2014 40.210.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-3.94.01.9690.000Cornet - SSRIs, 2024Levy, 2020Norby, 2016Engelstad (Controls unexposed, sick), 2014

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

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.22[0.97; 1.53]2,70425,3910%NACornet - SSRIs, 2024 Levy, 2020 Norby, 2016 3 unexposed, sick controlsunexposed, sick controls 0.60[0.14; 2.57]8126 -NAEngelstad (Controls unexposed, sick), 2014 10.510.01.0