Citalopram updated on 07-01-2025

Caesarean

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.
S18431
R78037
Lee (Controls exposed to TCAs), 2025 Cesarean delivery 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, ...) 0.66 [0.39;1.14] C
excluded (control group)
19/81   194/613 213 81
ref
S18412
R77774
Lee (Controls unexposed, general pop), 2025 Cesarean delivery 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, ...) 0.66 [0.40;1.11] 19/81   111,640/463,440 111,659 81
ref
S7696
R22838
Kivistö, 2016 Caesarean during pregnancy (anytime or not specified) retrospective cohort unexposed (general population or NOS) Adjustment: Yes Monotherapy: substance alone among all Antidep (SSRI, SNRI, ...) 1.00 [0.70;1.46] -/215   4,216/24,402 - 215
ref
S7179
R20193
Colvin, 2011 Caesarean (emergency and elective) during pregnancy (anytime or not specified) retrospective cohort (claims database) unexposed (general population or NOS) Adjustment: No Monotherapy: substance alone among the specific class of antidep (SSRI, SNRI, ...) 1.06 [0.94;1.20] C 379/1,136   29,801/92,995 30,180 1,136
ref
S18303
R77078
Heikkinen, 2002 Cesarean during pregnancy (anytime or not specified) prospective cohort unexposed (general population or NOS) Adjustment: No Matched Monotherapy: no or not specified 0.90 [0.05;16.60] C 1/11   1/10 2 11
ref
Total 4 studies 1.02 [0.89;1.17] 141,841 1,443
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 0.66[0.40; 1.11]111,659817%ROB confusion: seriousROB selection: lowROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: moderate Kivistö, 2016Kivistö, 2016 1.00[0.70; 1.46]-21513%ROB confusion: seriousROB selection: criticalROB classification: moderateROB missing: criticalROB mesure: moderateROB reporting: moderate Colvin, 2011Colvin, 2011 1.06[0.94; 1.20]30,1801,13679%ROB confusion: criticalROB selection: lowROB classification: criticalROB missing: unclearROB mesure: moderateROB reporting: moderate Heikkinen, 2002Heikkinen, 2002 0.90[0.05; 16.60]2110%ROB confusion: criticalROB selection: lowROB classification: lowROB missing: lowROB mesure: moderateROB reporting: moderate Total (4 studies) I2 = 6% 1.02[0.89; 1.17]141,8411,4430.25.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Controls unexposed, general pop;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.02[0.89; 1.17]141,8411,4436%NALee (Controls unexposed, general pop), 2025 Kivistö, 2016 Colvin, 2011 Heikkinen, 2002 4 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.02[0.89; 1.17]141,8411,4436%NALee (Controls unexposed, general pop), 2025 Kivistö, 2016 Colvin, 2011 Heikkinen, 2002 4 Tags Adjustment   - No  - No 1.06[0.94; 1.20]30,1821,1470%NAColvin, 2011 Heikkinen, 2002 2   - Yes  - Yes 0.84[0.57; 1.26]111,65929640%NALee (Controls unexposed, general pop), 2025 Kivistö, 2016 2 MatchedMatched 0.90[0.05; 16.60]211 -NAHeikkinen, 2002 1 Monotherapy   - no or not specified  - no or not specified 0.90[0.05; 16.60]211 -NAHeikkinen, 2002 1   - substance alone among all Antidep ( ...  - substance alone among all Antidep (SSRI, SNRI, ...) 0.84[0.57; 1.26]111,65929640%NALee (Controls unexposed, general pop), 2025 Kivistö, 2016 2   - substance alone among the specific ...  - substance alone among the specific class of antidep (SSRI, SNRI, ...) 1.06[0.94; 1.20]30,1801,136 -NAColvin, 2011 1 All studiesAll studies 1.02[0.89; 1.17]141,8411,4436%NALee (Controls unexposed, general pop), 2025 Kivistö, 2016 Colvin, 2011 Heikkinen, 2002 40.25.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-3.53.51.7840.000Lee (Controls unexposed, general pop), 2025Kivistö, 2016Colvin, 2011Heikkinen, 2002

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 18431

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.02[0.89; 1.17]146,0481,4436%NALee (Controls unexposed, general pop), 2025 Kivistö, 2016 Colvin, 2011 Heikkinen, 2002 4 exposed to other treatment, sick controlsexposed to other treatment, sick controls 0.66[0.39; 1.14]21381 -NALee (Controls exposed to TCAs), 2025 10.510.01.0