Sertraline updated on 07-01-2025

Postpartum hemorrhage

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.
S18438
R78186		 Lee (Controls exposed to TCAs), 2025 Postpartum haemorrhage during pregnancy (anytime or not specified) retrospective cohort (claims database) exposed to other treatment, sick excluded Adjustment: No Monotherapy: substance alone among all Antidep (SSRI, SNRI, ...) 1.58 [0.94;2.67] C
excluded (control group) 		39/643   24/613 63 643
ref
S18420
R77944		 Lee (Controls unexposed, general pop), 2025 Postpartum haemorrhage during pregnancy (anytime or not specified) retrospective cohort (claims database) unexposed (general population or NOS) Adjustment: Yes Monotherapy: substance alone among all Antidep (SSRI, SNRI, ...) 1.23 [0.88;1.71] 39/643   19,755/463,440 19,794 643
ref
S11456
R42099		 Palmsten b, 2013 Postpartum hemorrhage (ICD-9 code for 666.x) late pregnancy retrospective cohort (claims database) unexposed, sick Adjustment: Yes Monotherapy: substance alone among all Antidep (SSRI, SNRI, ...) Unexposed sick: old history of illness/treatment (> 12 months before pregnancy) or not specified 1.31 [1.12;1.54] 162/4,526   1,896/69,044 2,058 4,526
ref
S7178
R20148		 Colvin, 2011 Postpartum hemorrhage (>= 500 mls) during pregnancy (anytime or not specified) retrospective cohort (claims database) unexposed (general population or NOS) Adjustment: No Monotherapy: substance alone among the specific class of antidep (SSRI, SNRI, ...) 1.19 [1.00;1.42] 143/1,340   8,462/92,995 8,605 1,340
ref
Total 3 studies 1.25 [1.12;1.40] 30,457 6,509
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 Lee (Controls unexposed, general pop), 2025Lee, 2025 1 1.23[0.88; 1.71]19,79464311%ROB confusion: seriousROB selection: lowROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: moderate Palmsten b, 2013Palmsten b, 2013 1.31[1.12; 1.54]2,0584,52649%ROB confusion: seriousROB selection: lowROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Colvin, 2011Colvin, 2011 1.19[1.00; 1.42]8,6051,34040%ROB confusion: criticalROB selection: lowROB classification: criticalROB missing: unclearROB mesure: moderateROB reporting: moderate Total (3 studies) I2 = 0% 1.25[1.12; 1.40]30,4576,5090.55.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Controls unexposed, general pop;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.25[1.12; 1.40]30,4576,5090%NALee (Controls unexposed, general pop), 2025 Palmsten b, 2013 Colvin, 2011 3 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.20[1.03; 1.40]28,3991,9830%NALee (Controls unexposed, general pop), 2025 Colvin, 2011 2 unexposed, sickunexposed, sick 1.31[1.12; 1.54]2,0584,526 -NAPalmsten b, 2013 1 Tags Adjustment   - No  - No 1.19[1.00; 1.42]8,6051,340 -NAColvin, 2011 1   - Yes  - Yes 1.29[1.12; 1.49]21,8525,1690%NALee (Controls unexposed, general pop), 2025 Palmsten b, 2013 2 Monotherapy   - substance alone among all Antidep ( ...  - substance alone among all Antidep (SSRI, SNRI, ...) 1.29[1.12; 1.49]21,8525,1690%NALee (Controls unexposed, general pop), 2025 Palmsten b, 2013 2   - substance alone among the specific ...  - substance alone among the specific class of antidep (SSRI, SNRI, ...) 1.19[1.00; 1.42]8,6051,340 -NAColvin, 2011 1 Unexposed sick   - old history of illness/treatment (> ...  - old history of illness/treatment (> 12 months before pregnancy) or not specified 1.31[1.12; 1.54]2,0584,526 -NAPalmsten b, 2013 1 All studiesAll studies 1.25[1.12; 1.40]30,4576,5090%NALee (Controls unexposed, general pop), 2025 Palmsten b, 2013 Colvin, 2011 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 18438

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.20[1.03; 1.40]28,3991,9830%NALee (Controls unexposed, general pop), 2025 Colvin, 2011 2 unexposed, sick controlsunexposed, sick controls 1.31[1.12; 1.54]2,0584,526 -NAPalmsten b, 2013 1 exposed to other treatment, sick controlsexposed to other treatment, sick controls 1.58[0.94; 2.67]63643 -NALee (Controls exposed to TCAs), 2025 10.510.01.0