Escitalopram updated on 07-01-2025

Neonatal medical care

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.
S18435
R78134
Lee (Controls exposed to TCAs), 2025 Admission to neonatal intensive care unit (NICU) 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, ...) 0.40 [0.05;3.04] C
excluded (control group)
1/71   21/613 22 71
ref
S18414
R77829
Lee (Controls unexposed, general pop), 2025 Admission to neonatal intensive care unit (NICU) 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, ...) 0.48 [0.07;3.45] 1/71   8,566/463,440 8,567 71
ref
S18262
R76713
Cornet, 2024 Delayed neonatal adaptation (presence of at least one of the following: 5min Apgar score ≤5; positive pressure ventilation or intubation during delivery room resuscitation; or admission to the NICU with respiratory distress requiring invasive or non-invasive ventilation) late pregnancy retrospective cohort (claims database) unexposed (general population or NOS) Adjustment: Yes Monotherapy: substance alone among the specific class of antidep (SSRI, SNRI, ...) 3.86 [3.01;4.95] -/382   12,078/272,517 - 382
ref
S13122
R50020
Marks (Controls exposed to Bupropion), 2021 Neonatal intensive care unit admission during pregnancy (anytime or not specified) retrospective cohort exposed to other treatment, sick Adjustment: Yes Monotherapy: substance alone among all Antidep (SSRI, SNRI, ...) 1.68 [1.21;2.33] 172/581   91/406 263 581
ref
S6190
R16315
Klieger-Grossmann, 2012 Neonatal intensive care unit admission late pregnancy prospective cohort unexposed (general population or NOS) Adjustment: No Matched Monotherapy: substance alone among all Antidep (SSRI, SNRI, ...) 1.32 [0.59;2.94] C 14/172   12/191 26 172
ref
Total 4 studies 1.88 [0.95;3.72] 8,856 1,206
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 0.48[0.07; 3.45]8,567719%ROB confusion: moderateROB selection: lowROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: moderate Cornet, 2024Cornet, 2024 3.86[3.01; 4.95]-38234%ROB confusion: moderateROB selection: lowROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Marks (Controls exposed to Bupropion), 2021Marks, 2021 2 1.68[1.21; 2.33]26358133%ROB confusion: criticalROB selection: lowROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Klieger-Grossmann, 2012Klieger-Grossmann, 2012 1.32[0.59; 2.94]2617224%ROB confusion: criticalROB selection: moderateROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Total (4 studies) I2 = 86% 1.88[0.95; 3.72]8,8561,2060.210.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Controls unexposed, general pop; 2: Controls exposed to Bupropion;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.88[0.95; 3.72]8,8561,20686%NALee (Controls unexposed, general pop), 2025 Cornet, 2024 Marks (Controls exposed to Bupropion), 2021 Klieger-Grossmann, 2012 4 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.78[0.61; 5.19]8,59362580%NALee (Controls unexposed, general pop), 2025 Cornet, 2024 Klieger-Grossmann, 2012 3 exposed to other treatment, sickexposed to other treatment, sick 1.68[1.21; 2.33]263581 -NAMarks (Controls exposed to Bupropion), 2021 1 Tags Adjustment   - No  - No 1.32[0.59; 2.94]26172 -NAKlieger-Grossmann, 2012 1   - Yes  - Yes 2.08[0.93; 4.64]8,8301,03489%NALee (Controls unexposed, general pop), 2025 Cornet, 2024 Marks (Controls exposed to Bupropion), 2021 3 MatchedMatched 1.32[0.59; 2.94]26172 -NAKlieger-Grossmann, 2012 1 Monotherapy   - substance alone among all Antidep ( ...  - substance alone among all Antidep (SSRI, SNRI, ...) 1.58[1.17; 2.13]8,8568240%NALee (Controls unexposed, general pop), 2025 Marks (Controls exposed to Bupropion), 2021 Klieger-Grossmann, 2012 3   - substance alone among the specific ...  - substance alone among the specific class of antidep (SSRI, SNRI, ...) 3.86[3.01; 4.95]-382 -NACornet, 2024 1 All studiesAll studies 1.88[0.95; 3.72]8,8561,20686%NALee (Controls unexposed, general pop), 2025 Cornet, 2024 Marks (Controls exposed to Bupropion), 2021 Klieger-Grossmann, 2012 40.210.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-2.33.01.1930.000Lee (Controls unexposed, general pop), 2025Cornet, 2024Marks (Controls exposed to Bupropion), 2021Klieger-Grossmann, 2012

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

not enought points

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded 18435

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.78[0.61; 5.19]20,66262580%NALee (Controls unexposed, general pop), 2025 Cornet, 2024 Klieger-Grossmann, 2012 3 exposed to other treatment, sick controlsexposed to other treatment, sick controls 1.18[0.35; 3.95]28565246%NALee (Controls exposed to TCAs), 2025 Marks (Controls exposed to Bupropion), 2021 20.510.01.0