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

Perinatal death

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.
S7570
R22770		 Kivistö, 2016 Perinatal mortality during pregnancy (anytime or not specified) retrospective cohort unexposed (general population or NOS) Adjustment: Yes Monotherapy: SSRI only 1.94 [0.61;6.19] 3/358   130/24,402 133 358
ref
S5430
R21323		 Norby, 2016 Perinatal death (stillbirth and death within 7 days from birth) during pregnancy (anytime or not specified) population based cohort retrospective unexposed (general population or NOS) Adjustment: No Monotherapy: no or not specified 1.20 [1.00;1.50] -/17,736   -/718,533 - 17,736
ref
S11224
R41300		 Ban (Controls exposed to TCA), 2012 Perinatal death (stillbirth or neonatal death within the first 28 days postpartum) during pregnancy (anytime or not specified) population based cohort retrospective exposed to other treatment, sick excluded Adjustment: No Monotherapy: SSRI only 0.96 [0.59;1.55] C
excluded (control group) 		69/14,191   22/4,349 91 14,191
ref
S11225
R41303		 Ban (Controls unexposed, disease free), 2012 Perinatal death (stillbirth or neonatal death within the first 28 days postpartum) during pregnancy (anytime or not specified) population based cohort retrospective unexposed, disease free excluded Adjustment: Yes Monotherapy: SSRI only 1.60 [1.10;2.40]
excluded (control group) 		69/14,191   -/- - 14,191
ref
S11226
R41306		 Ban (Controls unexposed, sick), 2012 Perinatal death (stillbirth or neonatal death within the first 28 days postpartum) during pregnancy (anytime or not specified) population based cohort retrospective unexposed, sick Adjustment: Yes Monotherapy: SSRI only Unexposed sick: recent illness/treatment (during or juste before pregnancy or treatment stopped in view of pregnancy) 1.20 [0.60;2.30] 69/14,191   -/- - 14,191
ref
Total 3 studies 1.22 [1.00;1.47] 133 32,285
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 Kivistö, 2016Kivistö, 2016 1.94[0.61; 6.19]1333583%ROB confusion: seriousROB selection: criticalROB classification: moderateROB missing: criticalROB mesure: moderateROB reporting: moderate Norby, 2016Norby, 2016 1.20[1.00; 1.50]-17,73689%ROB confusion: criticalROB selection: lowROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Ban (Controls unexposed, sick), 2012Ban, 2012 1 1.20[0.60; 2.30]-14,1918%ROB confusion: seriousROB selection: criticalROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: moderate Total (3 studies) I2 = 0% 1.22[1.00; 1.47]13332,2850.55.01.0ROB: 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 1.22[1.00; 1.47]13332,2850%NAKivistö, 2016 Norby, 2016 Ban (Controls unexposed, sick), 2012 3 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.22[1.00; 1.49]13318,0940%NAKivistö, 2016 Norby, 2016 2 unexposed, sickunexposed, sick 1.20[0.61; 2.35]-14,191 -NABan (Controls unexposed, sick), 2012 1 Tags Adjustment   - No  - No 1.20[0.98; 1.47]-17,736 -NANorby, 2016 1   - Yes  - Yes 1.35[0.76; 2.42]13314,5490%NAKivistö, 2016 Ban (Controls unexposed, sick), 2012 2 Monotherapy   - no or not specified  - no or not specified 1.20[0.98; 1.47]-17,736 -NANorby, 2016 1   - SSRI only  - SSRI only 1.35[0.76; 2.42]13314,5490%NAKivistö, 2016 Ban (Controls unexposed, sick), 2012 2 Unexposed sick   - recent illness/treatment (during o ...  - recent illness/treatment (during or juste before pregnancy or treatment stopped in view of pregnancy) 1.20[0.61; 2.35]-14,191 -NABan (Controls unexposed, sick), 2012 1 All studiesAll studies 1.22[1.00; 1.47]13332,2850%NAKivistö, 2016 Norby, 2016 Ban (Controls unexposed, sick), 2012 30.55.01.0

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 11224, 11225

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.30[1.07; 1.59]19332,2856%NAKivistö, 2016 Norby, 2016 Ban (Controls unexposed, disease free), 2012 3 unexposed, sick controlsunexposed, sick controls 1.20[0.61; 2.35]6014,191 -NABan (Controls unexposed, sick), 2012 1 exposed to other treatment, sick controlsexposed to other treatment, sick controls 0.96[0.59; 1.55]9114,191 -NABan (Controls exposed to TCA), 2012 10.510.01.0