Escitalopram updated on 07-01-2025

Limb defects

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.
S7472
R22358		 Anderson, 2020 Any limb deficiency 1st trimester case control unexposed (general population or NOS) Adjustment: Yes Monotherapy: substance alone among all Antidep (SSRI, SNRI, ...) 1.86 [0.78;4.45] -/-   0/- - -
ref
S5890
R14784		 Ban (Controls unexposed, disease free), 2014 Limb malformations 1st trimester retrospective cohort (claims database) unexposed, disease free excluded Adjustment: Yes Monotherapy: substance alone among the specific class of antidep (SSRI, SNRI, ...) 0.69 [0.10;4.89]
excluded (control group) 		-/933   1,750/325,294 - 933
ref
S5891
R14799		 Ban (Controls unexposed, sick), 2014 Limb malformations 1st trimester retrospective cohort (claims database) unexposed, sick Adjustment: Yes Monotherapy: substance alone among the specific class of antidep (SSRI, SNRI, ...) Unexposed sick: intermediate history of illness/treatment (3-12 months before pregnancy) 0.58 [0.08;4.11] -/933   71/13,432 - 933
ref
S6015
R15513		 Jimenez-Solem (Controls unexposed, NOS), 2012 Congenital malformations of the limbs 1st trimester population based cohort retrospective unexposed (general population or NOS) excluded Adjustment: Yes Monotherapy: substance alone among the specific class of antidep (SSRI, SNRI, ...) 0.25 [0.04;1.75]
excluded (control group) 		1/293   11,785/843,797 11,786 293
ref
S6020
R15608		 Jimenez-Solem (Controls unexposed, sick), 2012 Congenital malformations of the limbs 1st trimester population based cohort retrospective unexposed, sick Adjustment: No Monotherapy: substance alone among the specific class of antidep (SSRI, SNRI, ...) Unexposed sick: intermediate history of illness/treatment (3-12 months before pregnancy) 0.19 [0.03;1.48] C 1/293   14/806 15 293
ref
S6245
R16538		 Malm, 2011 Musculoskeletal malformations (including limb defects) 1st trimester population based cohort retrospective unexposed (general population or NOS) Adjustment: Yes Monotherapy: no or not specified 1.22 [0.54;2.75] -/441   -/628,607 - 441
ref
Total 4 studies 1.05 [0.50;2.23] 15 1,667
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 Anderson, 2020Anderson, 2020 1.86[0.78; 4.45]--37%ROB confusion: seriousROB selection: criticalROB classification: criticalROB missing: lowROB mesure: criticalROB reporting: moderate Ban (Controls unexposed, sick), 2014Ban, 2014 1 0.58[0.08; 4.11]-93312%ROB confusion: seriousROB selection: moderateROB classification: criticalROB missing: lowROB mesure: criticalROB reporting: moderate Jimenez-Solem (Controls unexposed, sick), 2012Jimenez-Solem, 2012 2 0.19[0.03; 1.48]1529311%ROB confusion: criticalROB selection: moderateROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: critical Malm, 2011Malm, 2011 1.22[0.54; 2.75]-44139%ROB confusion: criticalROB selection: lowROB classification: criticalROB missing: lowROB mesure: criticalROB reporting: moderate Total (4 studies) I2 = 35% 1.05[0.50; 2.23]151,6670.05.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

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

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 0.72[0.26; 2.01]151,66731%NABan (Controls unexposed, sick), 2014 Jimenez-Solem (Controls unexposed, sick), 2012 Malm, 2011 3 case control studiescase control studies 1.86[0.78; 4.44]-- -NAAnderson, 2020 1 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.49[0.82; 2.69]-4410%NAAnderson, 2020 Malm, 2011 2 unexposed, sickunexposed, sick 0.34[0.08; 1.40]151,2260%NABan (Controls unexposed, sick), 2014 Jimenez-Solem (Controls unexposed, sick), 2012 2 Tags Adjustment   - No  - No 0.19[0.03; 1.48]15293 -NAJimenez-Solem (Controls unexposed, sick), 2012 1   - Yes  - Yes 1.37[0.78; 2.43]-1,3740%NAAnderson, 2020 Ban (Controls unexposed, sick), 2014 Malm, 2011 3 Monotherapy   - no or not specified  - no or not specified 1.22[0.54; 2.75]-441 -NAMalm, 2011 1   - substance alone among all Antidep ( ...  - substance alone among all Antidep (SSRI, SNRI, ...) 1.86[0.78; 4.44]-- -NAAnderson, 2020 1   - substance alone among the specific ...  - substance alone among the specific class of antidep (SSRI, SNRI, ...) 0.34[0.08; 1.40]151,2260%NABan (Controls unexposed, sick), 2014 Jimenez-Solem (Controls unexposed, sick), 2012 2 Unexposed sick   - intermediate history of illness/tre ...  - intermediate history of illness/treatment (3-12 months before pregnancy) 0.34[0.08; 1.40]151,2260%NABan (Controls unexposed, sick), 2014 Jimenez-Solem (Controls unexposed, sick), 2012 2 All studiesAll studies 1.05[0.50; 2.23]151,66735%NAAnderson, 2020 Ban (Controls unexposed, sick), 2014 Jimenez-Solem (Controls unexposed, sick), 2012 Malm, 2011 40.05.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-2.42.51.2450.000Anderson, 2020Ban (Controls unexposed, sick), 2014Jimenez-Solem (Controls unexposed, sick), 2012Malm, 2011

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 6015, 5890

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.13[0.58; 2.20]13,5271,66724%NAAnderson, 2020 Ban (Controls unexposed, disease free), 2014 Jimenez-Solem (Controls unexposed, NOS), 2012 Malm, 2011 4 unexposed, sick controlsunexposed, sick controls Out of scale0.34[0.08; 1.40]771,2260%NABan (Controls unexposed, sick), 2014 Jimenez-Solem (Controls unexposed, sick), 2012 20.510.01.0