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

Very low Apgar score (< 5) (at 5 min)

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
R76641		 Cornet - SSRIs, 2024 5 min Apgar ≤5 late pregnancy retrospective cohort (claims database) unexposed (general population or NOS) Adjustment: Yes Monotherapy: no or not specified 2.40 [1.93;2.99] 105/7,573   1,215/272,517 1,320 7,573
ref
S10057
R36525		 Ulbrich, 2021 5-minute Apgar <=5 3rd trimester retrospective cohort unexposed (general population or NOS) Adjustment: Yes Monotherapy: no or not specified 4.01 [0.92;9.03] 6/158   37/4,635 43 158
ref
S7980
R24319		 de Vries, 2013 Apgar score ≤ 5 at 5 min during pregnancy (anytime or not specified) prospective cohort unexposed (general population or NOS) Adjustment: No Monotherapy: SSRI only 3.60 [0.17;76.77] C 2/63   0/44 2 63
ref
Total 3 studies 2.45 [1.98;3.03] 1,365 7,794
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 2.40[1.93; 2.99]1,3207,57396%ROB confusion: moderateROB selection: lowROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Ulbrich, 2021Ulbrich, 2021 4.01[0.92; 9.03]431584%ROB confusion: seriousROB selection: unclearROB classification: criticalROB missing: moderateROB mesure: moderateROB reporting: moderate de Vries, 2013de Vries, 2013 3.60[0.17; 76.77]2630%ROB confusion: criticalROB selection: unclearROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: low Total (3 studies) I2 = 0% 2.45[1.98; 3.03]1,3657,7940.910.01.0ROB: 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 2.45[1.98; 3.03]1,3657,7940%NACornet - SSRIs, 2024 Ulbrich, 2021 de Vries, 2013 3 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 2.45[1.98; 3.03]1,3657,7940%NACornet - SSRIs, 2024 Ulbrich, 2021 de Vries, 2013 3 Tags Adjustment   - No  - No 3.60[0.17; 76.77]263 -NAde Vries, 2013 1   - Yes  - Yes 2.44[1.97; 3.03]1,3637,7310%NACornet - SSRIs, 2024 Ulbrich, 2021 2 Monotherapy   - no or not specified  - no or not specified 2.44[1.97; 3.03]1,3637,7310%NACornet - SSRIs, 2024 Ulbrich, 2021 2   - SSRI only  - SSRI only 3.60[0.17; 76.77]263 -NAde Vries, 2013 1 All studiesAll studies 2.45[1.98; 3.03]1,3657,7940%NACornet - SSRIs, 2024 Ulbrich, 2021 de Vries, 2013 30.510.01.0

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

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 2.45[1.98; 3.03]1,3657,7940%NACornet - SSRIs, 2024 Ulbrich, 2021 de Vries, 2013 30.510.01.0