Citalopram updated on 07-01-2025

Genital anomalies

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.
S7437
R21932
Bérard, 2017 Genital organs malformations 1st trimester retrospective cohort (claims database) unexposed, sick Adjustment: Yes Monotherapy: substance alone among all Antidep (SSRI, SNRI, ...) Unexposed sick: intermediate history of illness/treatment (3-12 months before pregnancy) 0.86 [0.37;1.99] -/584   -/14,847 - 584
ref
S5884
R14728
Ban (Controls unexposed, disease free), 2014 Genital system malformations 1st trimester retrospective cohort (claims database) unexposed, disease free excluded Adjustment: Yes Monotherapy: substance alone among the specific class of antidep (SSRI, SNRI, ...) 0.91 [0.43;1.93]
excluded (control group)
-/1,946   1,292/325,294 - 1,946
ref
S5885
R14743
Ban (Controls unexposed, sick), 2014 Genital system 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) 0.71 [0.32;1.56] -/1,946   67/13,432 - 1,946
ref
S10215
R37419
De Jonge, 2013 Genital malformations 1st trimester case control unexposed (general population or NOS) Adjustment: No Monotherapy: no or not specified 1.31 [0.08;21.42] C 0/35   314/29,502 314 35
ref
S6014
R15489
Jimenez-Solem (Controls unexposed, NOS), 2012 Congenital malformations of the external genital organs 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, ...) 1.70 [0.85;3.41]
excluded (control group)
8/1,606   2,504/843,797 2,512 1,606
ref
S6019
R15599
Jimenez-Solem (Controls unexposed, sick), 2012 Congenital malformations of the external genital organs 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) 2.01 [0.43;9.50] C 8/1,606   2/806 10 1,606
ref
Total 4 studies 0.88 [0.52;1.50] 324 4,171
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 Bérard, 2017Bérard, 2017 0.86[0.37; 1.99]-58440%ROB confusion: seriousROB selection: moderateROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: moderate Ban (Controls unexposed, sick), 2014Ban, 2014 1 0.71[0.32; 1.56]-1,94645%ROB confusion: seriousROB selection: moderateROB classification: criticalROB missing: lowROB mesure: criticalROB reporting: moderate De Jonge, 2013De Jonge, 2013 1.31[0.08; 21.42]314354%ROB confusion: criticalROB selection: criticalROB classification: criticalROB missing: lowROB mesure: criticalROB reporting: critical Jimenez-Solem (Controls unexposed, sick), 2012Jimenez-Solem, 2012 2 2.01[0.43; 9.50]101,60612%ROB confusion: criticalROB selection: moderateROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: critical Total (4 studies) I2 = 0% 0.88[0.52; 1.50]3244,1710.25.01.0ROB: 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 0.87[0.51; 1.50]104,1360%NABérard, 2017 Ban (Controls unexposed, sick), 2014 Jimenez-Solem (Controls unexposed, sick), 2012 3 case control studiescase control studies 1.31[0.08; 21.42]31435 -NADe Jonge, 2013 1 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.31[0.08; 21.42]31435 -NADe Jonge, 2013 1 unexposed, sickunexposed, sick 0.87[0.51; 1.50]104,1360%NABérard, 2017 Ban (Controls unexposed, sick), 2014 Jimenez-Solem (Controls unexposed, sick), 2012 3 Tags Adjustment   - No  - No 1.82[0.47; 7.06]3241,6410%NADe Jonge, 2013 Jimenez-Solem (Controls unexposed, sick), 2012 2   - Yes  - Yes 0.78[0.44; 1.38]-2,5300%NABérard, 2017 Ban (Controls unexposed, sick), 2014 2 Monotherapy   - no or not specified  - no or not specified 1.31[0.08; 21.42]31435 -NADe Jonge, 2013 1   - substance alone among all Antidep ( ...  - substance alone among all Antidep (SSRI, SNRI, ...) 0.86[0.37; 1.99]-584 -NABérard, 2017 1   - substance alone among the specific ...  - substance alone among the specific class of antidep (SSRI, SNRI, ...) 0.96[0.38; 2.41]103,55227%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) 0.87[0.51; 1.50]104,1360%NABérard, 2017 Ban (Controls unexposed, sick), 2014 Jimenez-Solem (Controls unexposed, sick), 2012 3 All studiesAll studies 0.88[0.52; 1.50]3244,1710%NABérard, 2017 Ban (Controls unexposed, sick), 2014 De Jonge, 2013 Jimenez-Solem (Controls unexposed, sick), 2012 40.25.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-3.43.21.7100.000Bérard, 2017Ban (Controls unexposed, sick), 2014De Jonge, 2013Jimenez-Solem (Controls unexposed, sick), 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 6014, 5884

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.28[0.77; 2.11]4,1093,5870%NABan (Controls unexposed, disease free), 2014 De Jonge, 2013 Jimenez-Solem (Controls unexposed, NOS), 2012 3 unexposed, sick controlsunexposed, sick controls 0.87[0.51; 1.50]684,1360%NABérard, 2017 Ban (Controls unexposed, sick), 2014 Jimenez-Solem (Controls unexposed, sick), 2012 30.510.01.0