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

Congenital heart 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.
S18158
R76356		 Chan (Controls exposed to TCA), 2024 Cardiac malformations 1st trimester retrospective cohort (claims database) exposed to other treatment, sick excluded Adjustment: No Monotherapy: SSRI only 0.73 [0.35;1.50] C
excluded (control group) 		24/956   11/322 35 956
ref
S18138
R76242		 Chan (Controls unexposed, general pop), 2024 Cardiac malformations 1st trimester retrospective cohort (claims database) unexposed (general population or NOS) excluded Adjustment: Yes Monotherapy: SSRI only 1.19 [0.68;2.11]
excluded (control group) 		24/956   8,107/462,377 8,131 956
ref
S18139
R76248		 Chan (Controls unexposed, sick), 2024 Cardiac malformations 1st trimester retrospective cohort (claims database) unexposed, sick Adjustment: Yes Monotherapy: SSRI only Unexposed sick: old history of illness/treatment (> 12 months before pregnancy) or not specified 1.10 [0.55;2.22] 16/714   95/4,413 111 714
ref
S12482
R47059		 Benevent, 2023 Circulatory system anomaly 1st trimester retrospective cohort (claims database) unexposed (general population or NOS) Adjustment: No Monotherapy: SSRI only 0.68 [0.28;1.65] C 5/1,653   649/146,855 654 1,653
ref
S16846
R70635		 Kawai, 2023 Congenital Heart Defects early pregnancy nested case control unexposed (general population or NOS) Adjustment: No Monotherapy: no or not specified 1.39 [0.44;4.35] 3/158   1,261/91,506 1,264 158
ref
S13112
R49966		 Marks - Sertraline (Controls exposed to Bupropion), 2021 Cardiac Malformations during pregnancy (anytime or not specified) excluded retrospective cohort exposed to other treatment, sick Adjustment: No Monotherapy: substance alone among all Antidep (SSRI, SNRI, ...) 1.22 [0.66;2.23] C
excluded (exposition period) 		64/1,653   13/406 77 1,653
ref
S7467
R22080		 Anderson, 2020 Any heart defect 1st trimester case control unexposed (general population or NOS) Adjustment: Yes Monotherapy: SSRI only 1.33 [1.15;1.54] -/-   0/- - -
ref
S6704
R18917		 Bérard - Non Sertraline SSRI, 2015 Cardiac malformations 1st trimester retrospective cohort (claims database) unexposed, sick Adjustment: Yes Monotherapy: SSRI only Unexposed sick: intermediate history of illness/treatment (3-12 months before pregnancy) 1.10 [0.82;1.48] 51/1,963   344/14,868 395 1,963
ref
S516
R15349		 Furu (Controls unexposed, NOS), 2015 Any cardiac defects 1st trimester population based cohort retrospective unexposed (general population or NOS) Adjustment: Yes Monotherapy: SSRI only 1.15 [1.05;1.26] 564/36,772   26,745/2,266,875 27,309 36,772
ref
S6691
R18754		 Furu (Controls unexposed, sibling), 2015 Any cardiac defects 1st trimester population based cohort retrospective sibling excluded Adjustment: Yes Monotherapy: SSRI only 0.92 [0.72;1.17]
excluded (control group) 		-/422   -/569 - 422
ref
S7348
R21403		 Wemakor, 2015 Congenital heart defects 1st trimester case control unexposed (general population or NOS) Adjustment: Yes Monotherapy: SSRI only 1.41 [1.07;1.86] 108/207   12,768/29,752 12,876 207
ref
S5881
R14669		 Ban (Controls exposed to TCA), 2014 Heart congenital malformations 1st trimester retrospective cohort (claims database) exposed to other treatment, sick excluded Adjustment: No Monotherapy: SSRI only 1.08 [0.65;1.77] C
excluded (control group) 		68/7,683   20/2,428 88 7,683
ref
S517
R14647		 Ban (Controls unexposed, disease free), 2014 Heart congenital malformations 1st trimester retrospective cohort (claims database) unexposed, disease free excluded Adjustment: Yes Monotherapy: SSRI only 1.14 [0.89;1.45]
excluded (control group) 		68/7,683   2,444/325,294 2,512 7,683
ref
S6700
R18874		 Ban (Controls unexposed, sick), 2014 Heart congenital malformations 1st trimester retrospective cohort (claims database) unexposed, sick Adjustment: Yes Monotherapy: SSRI only Unexposed sick: intermediate history of illness/treatment (3-12 months before pregnancy) 1.04 [0.76;1.41] 68/7,683   112/13,432 180 7,683
ref
S494
R342		 Huybrechts (Controls unexposed, NOS), 2014 Any cardiac malformations 1st trimester cohort unexposed (general population or NOS) excluded Adjustment: No Monotherapy: no or not specified 1.25 [1.13;1.38]
excluded (control group) 		416/46,144   6,403/885,115 6,819 46,144
ref
S6097
R15882		 Huybrechts (Controls unexposed, sick), 2014 Any cardiac malformations 1st trimester cohort unexposed, sick Adjustment: Yes Monotherapy: no or not specified Unexposed sick: old history of illness/treatment (> 12 months before pregnancy) or not specified 1.08 [0.94;1.23] 341/36,783   1,497/180,564 1,838 36,783
ref
S5386
R15148		 Margulis, 2013 Cardiac malformations (first year of life) 1st trimester retrospective cohort (claims database) unexposed (general population or NOS) Adjustment: No Matched Monotherapy: SSRI only 1.00 [0.50;2.00] 16/3,046   48/8,991 64 3,046
ref
S496
R61459		 Nordeng (Controls unexposed, NOS), 2012 Cardiovascular malformations 1st trimester cohort unexposed (general population or NOS) excluded Adjustment: Yes Monotherapy: no or not specified Partial overlapping 1.51 [0.67;3.43]
excluded (control group) 		6/462   541/61,648 547 462
ref
S7830
R61473		 Nordeng (Controls unexposed, sick), 2012 Cardiovascular malformations 1st trimester cohort unexposed, sick Adjustment: No Monotherapy: no or not specified Partial overlapping Unexposed sick: intermediate history of illness/treatment (3-12 months before pregnancy) 1.96 [0.65;5.85] C 6/462   7/1,048 13 462
ref
S493
R15238		 Colvin, 2011 Cardiovascular defects 1st trimester retrospective cohort (claims database) unexposed (general population or NOS) Adjustment: No Monotherapy: no or not specified 1.60 [1.10;2.31] 30/2,701   661/94,561 691 2,701
ref
S6999
R76905		 Reis (Controls exposed to TCA), 2010 Any cardiovascular defect early pregnancy population based cohort retrospective exposed to other treatment, sick excluded Adjustment: No Monotherapy: SSRI only 0.59 [0.39;0.89] C
excluded (control group) 		109/10,170   30/1,662 139 10,170
ref
S5410
R76900		 Reis (Controls unexposed, NOS), 2010 Any cardiovascular defect early pregnancy population based cohort retrospective unexposed (general population or NOS) Adjustment: Yes Monotherapy: SSRI only 0.99 [0.82;1.20] 109/10,170   -/1,062,190 - 10,170
ref
S499
R369		 Merlob, 2009 Nonsyndromic congenital heart malformations 1st trimester prospective cohort unexposed (general population or NOS) Adjustment: No Monotherapy: no or not specified 2.17 [1.07;4.39] 8/235   1,083/67,636 1,091 235
ref
S5958
R15307		 Diav-Citrin - Fluoxetine or Paroxetine, 2008 Major cardiovascular anomalies 1st trimester prospective cohort unexposed (general population or NOS) Adjustment: Yes Monotherapy: no or not specified 2.66 [0.80;8.90] 7/348   8/1,359 15 348
ref
S504
R352		 Einarson - Paroxetine, 2008 Cardiovascular defects 1st trimester prospective cohort unexposed (general population or NOS) Adjustment: No Monotherapy: no or not specified 1.10 [0.36;2.78] 9/1,174   -/- - 1,174
ref
S7288
R21079		 Maschi - Paroxetine, 2008 Cardiac malformations during pregnancy (anytime or not specified) excluded prospective cohort unexposed (general population or NOS) Adjustment: No Matched Monotherapy: no or not specified 18.45 [0.74;458.58] C
excluded (exposition period) 		1/58   0/348 1 58
ref
S520
R17637		 Oberlander a, 2008 Cardiovascular congenital defects 1st trimester retrospective cohort (claims database) unexposed (general population or NOS) Adjustment: No Monotherapy: SSRI only 1.36 [0.84;2.21] C 17/2,625   512/107,320 529 2,625
ref
S5394
R41660		 Davis, 2007 Congenital heart defects 1st trimester retrospective cohort (claims database) unexposed (general population or NOS) Adjustment: No Monotherapy: no or not specified 0.88 [0.54;1.43] C 17/805   1,171/49,031 1,188 805
ref
S5424
R16095		 Louik, 2007 Any cardiac defect 1st trimester case control unexposed (general population or NOS) Adjustment: Yes Monotherapy: no or not specified 1.20 [0.90;1.60] 100/260   3,624/9,324 3,724 260
ref
S507
R16623		 Vial - Paroxetine, 2006 Major cardiac defects 1st trimester prospective cohort unexposed (general population or NOS) Adjustment: No Matched Monotherapy: no or not specified 1.18 [0.24;5.87] C 3/535   3/631 6 535
ref
S6994
R19836		 Simon (Controls exposed to TCA), 2002 Cardiac malformations during pregnancy (anytime or not specified) retrospective cohort (claims database) exposed to other treatment, sick excluded Adjustment: No Monotherapy: SSRI only 4.60 [0.51;41.50] C
excluded (control group) 		4/185   1/209 5 185
ref
S492
R17424		 Simon (Controls unexposed, NOS), 2002 Cardiac malformations during pregnancy (anytime or not specified) excluded retrospective cohort (claims database) unexposed (general population or NOS) Adjustment: No Matched Monotherapy: SSRI only 9.20 [0.49;172.11] C
excluded (exposition period) 		4/185   0/185 4 185
ref
S513
R49343		 Kulin, 1998 Cardiac malformations (among neonates) 1st trimester prospective cohort unexposed (general population or NOS) Adjustment: No Monotherapy: no or not specified 0.53 [0.10;2.90] C 2/222   4/235 6 222
ref
Total 21 studies 1.17 [1.09;1.25] 51,954 108,516
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 Chan (Controls unexposed, sick), 2024Chan, 2024 1 1.10[0.55; 2.22]1117141%ROB confusion: seriousROB selection: moderateROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Benevent, 2023Benevent, 2023 0.68[0.28; 1.65]6541,6531%ROB confusion: criticalROB selection: lowROB classification: criticalROB missing: unclearROB mesure: moderateROB reporting: moderate Kawai, 2023Kawai, 2023 1.39[0.44; 4.35]1,2641580%ROB confusion: criticalROB selection: moderateROB classification: moderateROB missing: lowROB mesure: criticalROB reporting: moderate Anderson, 2020Anderson, 2020 1.33[1.15; 1.54]--15%ROB confusion: seriousROB selection: criticalROB classification: criticalROB missing: lowROB mesure: criticalROB reporting: moderate Bérard - Non Sertraline SSRI, 2015Bérard - Non Sertraline SSRI, 2015 1.10[0.82; 1.48]3951,9635%ROB confusion: seriousROB selection: moderateROB classification: criticalROB missing: unclearROB mesure: moderateROB reporting: moderate Furu (Controls unexposed, NOS), 2015Furu, 2015 2 1.15[1.05; 1.26]27,30936,77226%ROB confusion: criticalROB selection: moderateROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Wemakor, 2015Wemakor, 2015 1.41[1.07; 1.86]12,8762075%ROB confusion: criticalROB selection: criticalROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Ban (Controls unexposed, sick), 2014Ban, 2014 3 1.04[0.76; 1.41]1807,6834%ROB confusion: seriousROB selection: moderateROB classification: criticalROB missing: lowROB mesure: criticalROB reporting: moderate Huybrechts (Controls unexposed, sick), 2014Huybrechts, 2014 4 1.08[0.94; 1.23]1,83836,78317%ROB confusion: moderateROB selection: lowROB classification: moderateROB missing: moderateROB mesure: moderateROB reporting: moderate Margulis, 2013Margulis, 2013 1.00[0.50; 2.00]643,0461%ROB confusion: moderateROB selection: moderateROB classification: criticalROB missing: unclearROB mesure: moderateROB reporting: moderate Nordeng (Controls unexposed, sick), 2012Nordeng, 2012 5 1.96[0.65; 5.85]134620%ROB confusion: criticalROB selection: moderateROB classification: moderateROB missing: lowROB mesure: unclearROB reporting: moderate Colvin, 2011Colvin, 2011 1.60[1.10; 2.31]6912,7013%ROB confusion: criticalROB selection: moderateROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Reis (Controls unexposed, NOS), 2010Reis, 2010 6 0.99[0.82; 1.20]-10,17010%ROB confusion: criticalROB selection: moderateROB classification: moderateROB missing: lowROB mesure: unclearROB reporting: moderate Merlob, 2009Merlob, 2009 2.17[1.07; 4.39]1,0912351%ROB confusion: criticalROB selection: criticalROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Diav-Citrin - Fluoxetine or Paroxetine, 2008Diav-Citrin - Fluoxetine or Paroxetine, 2008 2.66[0.80; 8.90]153480%ROB confusion: criticalROB selection: moderateROB classification: moderateROB missing: unclearROB mesure: unclearROB reporting: moderate Einarson - Paroxetine, 2008Einarson - Paroxetine, 2008 1.10[0.36; 2.78]-1,1740%ROB confusion: criticalROB selection: unclearROB classification: moderateROB missing: unclearROB mesure: criticalROB reporting: moderate Oberlander a, 2008Oberlander a, 2008 1.36[0.84; 2.21]5292,6252%ROB confusion: criticalROB selection: moderateROB classification: criticalROB missing: unclearROB mesure: criticalROB reporting: moderate Davis, 2007Davis, 2007 0.88[0.54; 1.43]1,1888052%ROB confusion: criticalROB selection: moderateROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: moderate Louik, 2007Louik, 2007 1.20[0.90; 1.60]3,7242605%ROB confusion: moderateROB selection: criticalROB classification: criticalROB missing: lowROB mesure: criticalROB reporting: moderate Vial - Paroxetine, 2006Vial - Paroxetine, 2006 1.18[0.24; 5.87]65350%ROB confusion: criticalROB selection: moderateROB classification: moderateROB missing: unclearROB mesure: unclearROB reporting: unclear Kulin, 1998Kulin, 1998 0.53[0.10; 2.90]62220%ROB confusion: criticalROB selection: criticalROB classification: moderateROB missing: lowROB mesure: criticalROB reporting: moderate Total (21 studies) I2 = 11% 1.17[1.09; 1.25]51,954108,5160.210.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Controls unexposed, sick; 2: Controls unexposed, NOS; 3: Controls unexposed, sick; 4: Controls unexposed, sick; 5: Controls unexposed, sick; 6: Controls unexposed, NOS;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.12[1.05; 1.19]34,090107,8910%NAChan (Controls unexposed, sick), 2024 Benevent, 2023 Bérard - Non Sertraline SSRI, 2015 Furu (Controls unexposed, NOS), 2015 Ban (Controls unexposed, sick), 2014 Huybrechts (Controls unexposed, sick), 2014 Margulis, 2013 Nordeng (Controls unexposed, sick), 2012 Colvin, 2011 Reis (Controls unexposed, NOS), 2010 Merlob, 2009 Diav-Citrin - Fluoxetine or Paroxetine, 2008 Einarson - Paroxetine, 2008 Oberlander a, 2008 Davis, 2007 Vial - Paroxetine, 2006 Kulin, 1998 17 case control studiescase control studies 1.32[1.18; 1.49]17,8646250%NAKawai, 2023 Anderson, 2020 Wemakor, 2015 Louik, 2007 4 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.21[1.10; 1.33]49,41760,91122%NABenevent, 2023 Kawai, 2023 Anderson, 2020 Furu (Controls unexposed, NOS), 2015 Wemakor, 2015 Margulis, 2013 Colvin, 2011 Reis (Controls unexposed, NOS), 2010 Merlob, 2009 Diav-Citrin - Fluoxetine or Paroxetine, 2008 Einarson - Paroxetine, 2008 Oberlander a, 2008 Davis, 2007 Louik, 2007 Vial - Paroxetine, 2006 Kulin, 1998 16 unexposed, sickunexposed, sick 1.08[0.97; 1.21]2,53747,6050%NAChan (Controls unexposed, sick), 2024 Bérard - Non Sertraline SSRI, 2015 Ban (Controls unexposed, sick), 2014 Huybrechts (Controls unexposed, sick), 2014 Nordeng (Controls unexposed, sick), 2012 5 Tags Adjustment   - No  - No 1.28[1.04; 1.56]5,50613,6160%NABenevent, 2023 Kawai, 2023 Margulis, 2013 Nordeng (Controls unexposed, sick), 2012 Colvin, 2011 Merlob, 2009 Einarson - Paroxetine, 2008 Oberlander a, 2008 Davis, 2007 Vial - Paroxetine, 2006 Kulin, 1998 11   - Yes  - Yes 1.16[1.07; 1.25]46,44894,90022%NAChan (Controls unexposed, sick), 2024 Anderson, 2020 Bérard - Non Sertraline SSRI, 2015 Furu (Controls unexposed, NOS), 2015 Wemakor, 2015 Ban (Controls unexposed, sick), 2014 Huybrechts (Controls unexposed, sick), 2014 Reis (Controls unexposed, NOS), 2010 Diav-Citrin - Fluoxetine or Paroxetine, 2008 Louik, 2007 10 MatchedMatched 1.03[0.54; 1.94]703,5810%NAMargulis, 2013 Vial - Paroxetine, 2006 2 Monotherapy   - no or not specified  - no or not specified 1.21[1.04; 1.42]9,83643,68316%NAKawai, 2023 Huybrechts (Controls unexposed, sick), 2014 Nordeng (Controls unexposed, sick), 2012 Colvin, 2011 Merlob, 2009 Diav-Citrin - Fluoxetine or Paroxetine, 2008 Einarson - Paroxetine, 2008 Davis, 2007 Louik, 2007 Vial - Paroxetine, 2006 Kulin, 1998 11   - SSRI only  - SSRI only 1.17[1.07; 1.26]42,11864,83315%NAChan (Controls unexposed, sick), 2024 Benevent, 2023 Anderson, 2020 Bérard - Non Sertraline SSRI, 2015 Furu (Controls unexposed, NOS), 2015 Wemakor, 2015 Ban (Controls unexposed, sick), 2014 Margulis, 2013 Reis (Controls unexposed, NOS), 2010 Oberlander a, 2008 10 Partial overlappingPartial overlapping 1.96[0.65; 5.85]13462 -NANordeng (Controls unexposed, sick), 2012 1 Unexposed sick   - intermediate history of illness/tre ...  - intermediate history of illness/treatment (3-12 months before pregnancy) 1.09[0.89; 1.35]58810,1080%NABérard - Non Sertraline SSRI, 2015 Ban (Controls unexposed, sick), 2014 Nordeng (Controls unexposed, sick), 2012 3   - old history of illness/treatment (> ...  - old history of illness/treatment (> 12 months before pregnancy) or not specified 1.08[0.95; 1.23]1,94937,4970%NAChan (Controls unexposed, sick), 2024 Huybrechts (Controls unexposed, sick), 2014 2 All studiesAll studies 1.17[1.09; 1.25]51,954108,51611%NAChan (Controls unexposed, sick), 2024 Benevent, 2023 Kawai, 2023 Anderson, 2020 Bérard - Non Sertraline SSRI, 2015 Furu (Controls unexposed, NOS), 2015 Wemakor, 2015 Ban (Controls unexposed, sick), 2014 Huybrechts (Controls unexposed, sick), 2014 Margulis, 2013 Nordeng (Controls unexposed, sick), 2012 Colvin, 2011 Reis (Controls unexposed, NOS), 2010 Merlob, 2009 Diav-Citrin - Fluoxetine or Paroxetine, 2008 Einarson - Paroxetine, 2008 Oberlander a, 2008 Davis, 2007 Louik, 2007 Vial - Paroxetine, 2006 Kulin, 1998 210.210.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-2.02.21.0450.000Chan (Controls unexposed, sick), 2024Benevent, 2023Kawai, 2023Anderson, 2020Bérard - Non Sertraline SSRI, 2015Furu (Controls unexposed, NOS), 2015Wemakor, 2015Ban (Controls unexposed, sick), 2014Huybrechts (Controls unexposed, sick), 2014Margulis, 2013Nordeng (Controls unexposed, sick), 2012Colvin, 2011Reis (Controls unexposed, NOS), 2010Merlob, 2009Diav-Citrin - Fluoxetine or Paroxetine, 2008Einarson - Paroxetine, 2008Oberlander a, 2008Davis, 2007Louik, 2007Vial - Paroxetine, 2006Kulin, 1998

Asymetry test p-value = 0.5581 (by Egger's regression)

slope=0.1316 (0.0456); intercept=0.2093 (0.3510); t=0.5961; p=0.5581

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded 6994, 6999, 496, 5881, 517, 494, 6691, 18158, 18138

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.21[1.14; 1.28]67,526116,1567%NAChan (Controls unexposed, general pop), 2024 Benevent, 2023 Kawai, 2023 Anderson, 2020 Furu (Controls unexposed, NOS), 2015 Wemakor, 2015 Ban (Controls unexposed, disease free), 2014 Huybrechts (Controls unexposed, NOS), 2014 Margulis, 2013 Nordeng (Controls unexposed, NOS), 2012 Colvin, 2011 Reis (Controls unexposed, NOS), 2010 Merlob, 2009 Diav-Citrin - Fluoxetine or Paroxetine, 2008 Einarson - Paroxetine, 2008 Oberlander a, 2008 Davis, 2007 Louik, 2007 Vial - Paroxetine, 2006 Kulin, 1998 20 unexposed, sick controlsunexposed, sick controls 1.08[0.97; 1.21]2,53747,6050%NAChan (Controls unexposed, sick), 2024 Bérard - Non Sertraline SSRI, 2015 Ban (Controls unexposed, sick), 2014 Huybrechts (Controls unexposed, sick), 2014 Nordeng (Controls unexposed, sick), 2012 5 exposed to other treatment, sick controlsexposed to other treatment, sick controls 0.76[0.52; 1.13]26218,80940%NAChan (Controls exposed to TCA), 2024 Ban (Controls exposed to TCA), 2014 Reis (Controls exposed to TCA), 2010 3 siblingssiblings 0.92[0.72; 1.17]-422 -NAFuru (Controls unexposed, sibling), 2015 10.510.01.0

Umbrella review (other published meta-analyses)

Published MAControlPeriodTE95% CIn exposedkI2 Viswanathan - SSRIs (Cardiac anomalies)Viswanathan - SSRIs (Cardiac anomalies) 1.07[0.96; 1.20]0%-Wwhatever (meta-analysis)Anyduring pregnancy (anytime or not specified)studies TTT3 Myles - SSRI (Cardiac malformations)Myles - SSRI (Cardiac malformations) 1.15[1.00; 1.32]34%-Wwhatever (meta-analysis)T1+at least 1st trimesterstudies TTT26 Wang - SSRI (Cardiac malformations)Wang - SSRI (Cardiac malformations) 1.06[0.94; 1.18]28%-Wwhatever (meta-analysis)T11st trimesterstudies TTT4 Biffi - SSRI (Cardiovascular malformations)Biffi - SSRI (Cardiovascular malformations) 1.26[1.13; 1.39]54%-Wwhatever (meta-analysis)T11st trimesterstudies TTT19 Nikfar - SSRI (Cardiovascular malformations)Nikfar - SSRI (Cardiovascular malformations) 1.19[0.39; 3.64]NA-Wwhatever (meta-analysis)Anyduring pregnancy (anytime or not specified)studies TTT19 Rahimi - SSRI (Cardiovascular malformations)Rahimi - SSRI (Cardiovascular malformations) 1.19[0.53; 2.68]NA-Wwhatever (meta-analysis)T1+at least 1st trimesterstudies TTT8 Zhang - SSRI (Cardiovascular related malforma ...Zhang - SSRI (Cardiovascular related malformations) 1.26[1.13; 1.39]54%-Wwhatever (meta-analysis)T11st trimesterstudies TTT19 Huang - SSRIs (Congenital cardiovascular abno ...Huang - SSRIs (Congenital cardiovascular abnormalities) 1.25[1.20; 1.30]0%-U,GPunexposed (general population or NOS)Anyduring pregnancy (anytime or not specified)studies TTT17 De Vries - SSRI (Congenital Heart Defects)De Vries - SSRI (Congenital Heart Defects) 1.25[1.15; 1.37]33%-Wwhatever (meta-analysis)T11st trimesterstudies TTT16 Gao - SSRI (Congenital heart defects)Gao - SSRI (Congenital heart defects) 1.24[1.11; 1.37]59%-U,GPunexposed (general population or NOS)T11st trimesterstudies TTT18 Gao - SSRI (Congenital heart defects)Gao - SSRI (Congenital heart defects) 1.06[0.90; 1.26]33.9%-U,Sunexposed, sickT11st trimesterstudies TTT6 metaPregmetaPreg 1.17[1.09; 1.25]11%108,516----Chan (Controls unexposed, sick), 2024 Benevent, 2023 Kawai, 2023 Anderson, 2020 Bérard - Non Sertraline SSRI, 2015 Furu (Controls unexposed, NOS), 2015 Wemakor, 2015 Ban (Controls unexposed, sick), 2014 Huybrechts (Controls unexposed, sick), 2014 Margulis, 2013 Nordeng (Controls unexposed, sick), 2012 Colvin, 2011 Reis (Controls unexposed, NOS), 2010 Merlob, 2009 Diav-Citrin - Fluoxetine or Paroxetine, 2008 Einarson - Paroxetine, 2008 Oberlander a, 2008 Davis, 2007 Louik, 2007 Vial - Paroxetine, 2006 Kulin, 1998 210.510.01.0