Escitalopram updated on 07-01-2025

Low Apgar score (< 7) (at 5 min)

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
R78132
Lee (Controls exposed to TCAs), 2025 5-minute Apgar score<7 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, ...) 0.78 [0.04;14.32] C
excluded (control group)
0/71   5/613 5 71
ref
S18414
R77827
Lee (Controls unexposed, general pop), 2025 5-minute Apgar score<7 during pregnancy (anytime or not specified) retrospective cohort (claims database) unexposed (general population or NOS) Adjustment: No Monotherapy: substance alone among all Antidep (SSRI, SNRI, ...) 1.90 [0.12;30.72] C 0/71   1,721/463,440 1,721 71
ref
S18219
R76443
Martin, 2024 Low Apgar score at 5 min (<7) during pregnancy (anytime or not specified) population based cohort retrospective unexposed (general population or NOS) Adjustment: Yes Monotherapy: substance alone among all Antidep (SSRI, SNRI, ...) 1.75 [1.58;1.93] 443/14,906   30,996/2,078,011 31,439 14,906
ref
S13122
R50027
Marks (Controls exposed to Bupropion), 2021 5 Min APGAR <7 during pregnancy (anytime or not specified) retrospective cohort exposed to other treatment, sick Adjustment: No Monotherapy: substance alone among all Antidep (SSRI, SNRI, ...) 0.91 [0.62;1.35] C 66/581   50/406 116 581
ref
Total 3 studies 1.33 [0.74;2.38] 33,276 15,558
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 1.90[0.12; 30.72]1,721714%ROB confusion: criticalROB selection: lowROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: moderate Martin, 2024Martin, 2024 1.75[1.58; 1.93]31,43914,90653%ROB confusion: seriousROB selection: lowROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Marks (Controls exposed to Bupropion), 2021Marks, 2021 2 0.91[0.62; 1.35]11658143%ROB confusion: criticalROB selection: lowROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Total (3 studies) I2 = 80% 1.33[0.74; 2.38]33,27615,5580.25.01.0ROB: 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 1.33[0.74; 2.38]33,27615,55880%NALee (Controls unexposed, general pop), 2025 Martin, 2024 Marks (Controls exposed to Bupropion), 2021 3 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.75[1.58; 1.93]33,16014,9770%NALee (Controls unexposed, general pop), 2025 Martin, 2024 2 exposed to other treatment, sickexposed to other treatment, sick 0.91[0.62; 1.35]116581 -NAMarks (Controls exposed to Bupropion), 2021 1 Tags Adjustment   - No  - No 0.93[0.63; 1.36]1,8376520%NALee (Controls unexposed, general pop), 2025 Marks (Controls exposed to Bupropion), 2021 2   - Yes  - Yes 1.75[1.58; 1.93]31,43914,906 -NAMartin, 2024 1 Monotherapy   - substance alone among all Antidep ( ...  - substance alone among all Antidep (SSRI, SNRI, ...) 1.33[0.74; 2.38]33,27615,55880%NALee (Controls unexposed, general pop), 2025 Martin, 2024 Marks (Controls exposed to Bupropion), 2021 3 All studiesAll studies 1.33[0.74; 2.38]33,27615,55880%NALee (Controls unexposed, general pop), 2025 Martin, 2024 Marks (Controls exposed to Bupropion), 2021 30.25.01.0

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 18435

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.75[1.58; 1.93]33,16014,9770%NALee (Controls unexposed, general pop), 2025 Martin, 2024 2 exposed to other treatment, sick controlsexposed to other treatment, sick controls 0.91[0.62; 1.34]1216520%NALee (Controls exposed to TCAs), 2025 Marks (Controls exposed to Bupropion), 2021 20.510.01.0