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

Neonatal hypoglycemia

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.
S14988
R61342		 Gover, 2023 Need for hypoglycemia treatment throughout pregnancy retrospective cohort unexposed (general population or NOS) Adjustment: No Matched Monotherapy: no or not specified 0.46 [0.13;1.59] C 8/21   12/21 20 21
ref
S5461
R24129		 Levy, 2020 Hypoglycemia throughout pregnancy retrospective cohort unexposed (general population or NOS) Adjustment: No Matched Monotherapy: no or not specified 14.03 [0.78;253.38] C 6/82   0/82 6 82
ref
S10062
R36574		 Bracero, 2016 Hypoglycemia days before delivery retrospective cohort unexposed, sick Adjustment: No Monotherapy: no or not specified 0.48 [0.03;9.23] C 0/6   13/85 13 6
ref
S5430
R21357		 Norby, 2016 Hypoglycemia during pregnancy (anytime or not specified) population based cohort retrospective unexposed (general population or NOS) Adjustment: Yes Monotherapy: no or not specified 1.30 [1.20;1.40] 701/17,736   17,439/718,533 18,140 17,736
ref
S12948
R49139		 Engelstad (Controls unexposed, sick), 2014 Hypoglycemia during pregnancy (anytime or not specified) retrospective cohort unexposed, sick Adjustment: No Monotherapy: SSRI only 2.60 [0.50;13.67] C 5/126   2/128 7 126
ref
S15011
R61497		 Lennestal, 2007 Neonatal hypoglycemia late pregnancy population based cohort retrospective unexposed (general population or NOS) Adjustment: Yes Monotherapy: no or not specified 1.32 [1.05;1.68] 73/-   -/- - -
ref
Total 6 studies 1.30 [1.09;1.54] 18,186 17,971
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 Gover, 2023Gover, 2023 0.46[0.13; 1.59]20212%ROB confusion: seriousROB selection: unclearROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: moderate Levy, 2020Levy, 2020 14.03[0.78; 253.38]6820%ROB confusion: criticalROB selection: criticalROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Bracero, 2016Bracero, 2016 0.48[0.03; 9.23]1360%ROB confusion: criticalROB selection: criticalROB classification: criticalROB missing: unclearROB mesure: moderateROB reporting: moderate Norby, 2016Norby, 2016 1.30[1.20; 1.40]18,14017,73665%ROB confusion: seriousROB selection: lowROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Engelstad (Controls unexposed, sick), 2014Engelstad, 2014 1 2.60[0.50; 13.67]71261%ROB confusion: criticalROB selection: criticalROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Lennestal, 2007Lennestal, 2007 1.32[1.05; 1.68]--32%ROB confusion: criticalROB selection: lowROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Total (6 studies) I2 = 22% 1.30[1.09; 1.54]18,18617,9710.250.01.0ROB: 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 1.30[1.09; 1.54]18,18617,97122%NAGover, 2023 Levy, 2020 Bracero, 2016 Norby, 2016 Engelstad (Controls unexposed, sick), 2014 Lennestal, 2007 6 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.29[1.04; 1.59]18,16617,83944%NAGover, 2023 Levy, 2020 Norby, 2016 Lennestal, 2007 4 unexposed, sickunexposed, sick 1.74[0.41; 7.38]201320%NABracero, 2016 Engelstad (Controls unexposed, sick), 2014 2 Tags Adjustment   - No  - No 1.38[0.33; 5.84]4623552%NAGover, 2023 Levy, 2020 Bracero, 2016 Engelstad (Controls unexposed, sick), 2014 4   - Yes  - Yes 1.30[1.21; 1.40]18,14017,7360%NANorby, 2016 Lennestal, 2007 2 MatchedMatched 1.96[0.07; 53.52]2610378%NAGover, 2023 Levy, 2020 2 Monotherapy   - no or not specified  - no or not specified 1.28[1.06; 1.55]18,17917,84530%NAGover, 2023 Levy, 2020 Bracero, 2016 Norby, 2016 Lennestal, 2007 5   - SSRI only  - SSRI only 2.60[0.50; 13.67]7126 -NAEngelstad (Controls unexposed, sick), 2014 1 All studiesAll studies 1.30[1.09; 1.54]18,18617,97122%NAGover, 2023 Levy, 2020 Bracero, 2016 Norby, 2016 Engelstad (Controls unexposed, sick), 2014 Lennestal, 2007 60.250.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-3.53.81.8080.000Gover, 2023Levy, 2020Bracero, 2016Norby, 2016Engelstad (Controls unexposed, sick), 2014Lennestal, 2007

Asymetry test p-value = 0.9258 (by Egger's regression)

slope=0.2592 (0.0577); intercept=0.0627 (0.6322); t=0.0992; p=0.9258

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) 1.29[1.04; 1.59]18,23017,83944%NAGover, 2023 Levy, 2020 Norby, 2016 Lennestal, 2007 4 unexposed, sick controlsunexposed, sick controls 1.74[0.41; 7.38]201320%NABracero, 2016 Engelstad (Controls unexposed, sick), 2014 20.510.01.0