Selective Serotonin Reuptake Inhibitor (SSRI) - Medication and Pregnancy KB

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

Neonatal disorders (as a whole)

R analysis

id	Study	Lib. in paper	Exposition period	Study type All studies Case control excluded Only case control	Control type	Tags	OR 95%CI	x1/n1 x0/n0	no cases	no exposed	ROB	Ref.
S18442 R78273	Lee (Controls exposed to TCAs), 2025	Any neonatal outcomes (preterm, low birth weight, small for gestational age, large for gestational age, low Apgar score,	during pregnancy (anytime or not specified)	retrospective cohort (claims database)	exposed to other treatment, sick excluded	Adjustment: No Monotherapy: SSRI only	0.94 [0.78;1.14] ^C excluded (control group)	763/1,465 328/613	1,091	1,465		ref
S18408 R77695	Lee (Controls unexposed, general pop), 2025	Any neonatal outcomes (preterm, low birth weight, small for gestational age, large for gestational age, low Apgar score,	during pregnancy (anytime or not specified)	retrospective cohort (claims database)	unexposed (general population or NOS)	Adjustment: Yes Monotherapy: SSRI only	1.73 [1.55;1.93]	763/1,465 161,405/463,440	162,168	1,465		ref
S5461 R18421	Levy, 2020	Composite adverse neonatal outcome ( >=1 early neonatal complications: seizures, IVH, hypoglycemia, mechanical ventilation, PPHN, respiratory distress syndrome, NEC, phototherapy, sepsis, blood transfusion, and neonatal death)	throughout pregnancy	retrospective cohort	unexposed (general population or NOS)	Adjustment: Yes Matched Monotherapy: no or not specified	1.70 [1.30;3.90]	27/82 7/82	34	82		ref
S7289 R21082	Maschi - Fluoxetine, 2008	Neonatal complications	during pregnancy (anytime or not specified)	prospective cohort	unexposed (general population or NOS)	Adjustment: No Matched Monotherapy: no or not specified	1.00 [0.12;8.59] ^C	1/32 6/192	7	32		ref
S7288 R21080	Maschi - Paroxetine, 2008	Neonatal complications	during pregnancy (anytime or not specified)	prospective cohort	unexposed (general population or NOS)	Adjustment: No Matched Monotherapy: no or not specified	1.06 [0.30;3.74] ^C	3/58 17/348	20	58		ref
S508 R17593	Sivojelezova - Citalopram, 2005	Neonatal complications in general	3rd trimester	prospective cohort	unexposed (general population or NOS)	Adjustment: No Matched Monotherapy: no or not specified	1.50 [1.00;2.40]	20/63 33/158	53	63		ref
S5954 R15278	Costei - Paroxetine (Controls unexposed, NOS), 2002	Neonatal complications	3rd trimester	prospective cohort	unexposed (general population or NOS) excluded	Adjustment: No Matched Monotherapy: no or not specified	7.26 [0.89;59.09] ^C excluded (control group)	12/55 1/27	13	55		ref
S5953 R15275	Costei - Paroxetine (Controls unexposed, sick), 2002	Neonatal complications	3rd trimester	prospective cohort	unexposed, sick	Adjustment: No Matched Monotherapy: no or not specified Unexposed sick: recent illness/treatment (during or juste before pregnancy or treatment stopped in view of pregnancy)	3.49 [0.72;16.87] ^C	12/55 2/27	14	55		ref
					Total	6 studies	1.71 [1.54;1.90]		162,296	1,755
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

1: Controls unexposed, general pop; 2: Controls unexposed, sick;

Sensitivity analysis

Publication bias and p-hacking diagnosis

funnel plot

Asymetry test p-value = 0.5659 (by Egger's regression)

slope=0.5564 (0.0460); intercept=-0.2219 (0.3551); t=0.6249; p=0.5659

p values plot

Sub-groups analysis using all included studies

excluded 5954, 18442