Amitriptyline updated on 07-01-2025

Preterm (< 37 weeks)

id	Study   Auto Lee (Controls exposed to SSRI), 2025Lee (Controls unexposed, general pop), 2025Martin, 2024Ozturk, 2016	Lib. in paper	Exposition period  Auto during pregnancy (anytime or not specified)1st trimester2nd trimester3rd trimester2nd and/or 3rd trimesterthroughout pregnancyearly pregnancydays before deliverylate pregnancypreconception-onlypericonceptionalpreconceptional for kinetic reasonat least 1st trimester3 months (or more) before pregnancy or during pregnancy1st and 2nd trimester3 months or more before pregnancy or1st trimesterPaternal exp. genotoxic window only (0–3 months preconception)Paternal exposure: epigenetic window only (3–xxx months preconception)Paternal exposure: genotoxic/epigenetic window (0–xxx months preconception)Paternal exposure: other window	Study type  All studies Case control excluded Only case control	Control type    Auto unexposed (general population or NOS)unexposed, sickunexposed, disease freeexposed to other treatment, sicknot specifiedsiblingwhatever (meta-analysis)	Tags	OR 95%CI	x1/n1 x0/n0	no cases	no exposed	ROB	Ref.
S18423 R77974	Lee (Controls exposed to SSRI), 2025	Preterm birth (infant born at gestational age <37 weeks)	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, ...)	1.04 [0.68;1.60] C excluded (control group)	28/301   131/1,465	159	301		ref
S18411 R77759	Lee (Controls unexposed, general pop), 2025	Preterm birth (infant born at gestational age <37 weeks)	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, ...)	1.04 [0.71;1.54]	28/301   28,543/463,440	28,571	301		ref
S18306 R77093	Martin, 2024	Preterm delivery (delivery at <259 days (37 weeks’))	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, ...)	1.36 [1.23;1.52]	405/4,773   119,950/2,408,707	120,355	4,773		ref
S11597 R42498	Ozturk, 2016	Preterm Births (<37 weeks)	at least 1st trimester	prospective cohort	unexposed (general population or NOS)	Adjustment: No Monotherapy: no or not specified	3.99 [0.19;83.55] C	0/4   8/246	8	4		ref
					Total	3 studies	1.31 [1.12;1.53]		148,934	5,078
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

Sensitivity analysis

Publication bias and p-hacking diagnosis

Sub-groups analysis using all included studies

excluded 18423