Sertraline updated on 07-01-2025

ADHD (Attention deficit hyperactivity disorder): Diagnosis/Risk

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.
S18383
R77493
Heuvelman, 2023 Attention deficit hyperactivity disorder -Medical codes or therapy records that indicated that the child had been prescribed ADHD medication - Mean age at end of follow-up 10.04 years, range 4–22 years during pregnancy (anytime or not specified) retrospective cohort (claims database) unexposed, sick Adjustment: Yes Monotherapy: no or not specified Unexposed sick: intermediate history of illness/treatment (3-12 months before pregnancy) 1.20 [0.71;2.04] -/2,088   -/16,330 - 2,088
ref
S18249
R76871
Suarez (Controls unexposed, discontinuers), 2022 Attention Deficit Hyperactivity Disorder - ≥ 2 dates with ICD-9 Dx 314.xx or ≥ 2 dispensings or 1 diagnosis and 1 dispensing - At ≥ 2 years of age 2nd and/or 3rd trimester retrospective cohort (claims database) unexposed, sick Adjustment: Yes Monotherapy: no or not specified Unexposed sick: recent illness/treatment (during or juste before pregnancy or treatment stopped in view of pregnancy) 1.04 [0.90;1.21] 1,544/55,722   323/11,529 1,867 55,722
ref
S18250
R76872
Suarez (Controls unexposed, general pop), 2022 Attention Deficit Hyperactivity Disorder - ≥ 2 dates with ICD-9 Dx 314.xx or ≥ 2 dispensings or 1 diagnosis and 1 dispensing - At ≥ 2 years of age 2nd and/or 3rd trimester retrospective cohort (claims database) unexposed (general population or NOS) excluded Adjustment: Yes Monotherapy: no or not specified 1.16 [1.10;1.23]
excluded (control group)
1,546/55,788   52,380/2,996,295 53,926 55,788
ref
Total 2 studies 1.05 [0.91;1.21] 1,867 57,810
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 Heuvelman, 2023Heuvelman, 2023 1.20[0.71; 2.04]-2,0887%ROB confusion: seriousROB selection: lowROB classification: criticalROB missing: criticalROB mesure: moderateROB reporting: low Suarez (Controls unexposed, discontinuers), 2022Suarez, 2022 1 1.04[0.90; 1.21]1,86755,72293%ROB confusion: seriousROB selection: lowROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Total (2 studies) I2 = 0% 1.05[0.91; 1.21]1,86757,8100.55.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Controls unexposed, discontinuers;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.05[0.91; 1.21]1,86757,8100%NAHeuvelman, 2023 Suarez (Controls unexposed, discontinuers), 2022 2 case control studiescase control studies 0 Type of controls unexposed, sickunexposed, sick 1.05[0.91; 1.21]1,86757,8100%NAHeuvelman, 2023 Suarez (Controls unexposed, discontinuers), 2022 2 Tags Adjustment   - Yes  - Yes 1.05[0.91; 1.21]1,86757,8100%NAHeuvelman, 2023 Suarez (Controls unexposed, discontinuers), 2022 2 Monotherapy   - no or not specified  - no or not specified 1.05[0.91; 1.21]1,86757,8100%NAHeuvelman, 2023 Suarez (Controls unexposed, discontinuers), 2022 2 Unexposed sick   - intermediate history of illness/tre ...  - intermediate history of illness/treatment (3-12 months before pregnancy) 1.20[0.71; 2.03]-2,088 -NAHeuvelman, 2023 1   - recent illness/treatment (during o ...  - recent illness/treatment (during or juste before pregnancy or treatment stopped in view of pregnancy) 1.04[0.90; 1.21]1,86755,722 -NASuarez (Controls unexposed, discontinuers), 2022 1 All studiesAll studies 1.05[0.91; 1.21]1,86757,8100%NAHeuvelman, 2023 Suarez (Controls unexposed, discontinuers), 2022 20.55.01.0

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 18250

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.16[1.10; 1.23]53,92655,788 -NASuarez (Controls unexposed, general pop), 2022 1 unexposed, sick controlsunexposed, sick controls 1.05[0.91; 1.21]1,86757,8100%NAHeuvelman, 2023 Suarez (Controls unexposed, discontinuers), 2022 20.510.01.0