Serotonin and Noradrenaline Reuptake Inhibitors (SNRI) updated on 07-01-2025

Late intrauterine deaths (> 22 weeks) / Stillbirths

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.
S11684
R42940		 Ankarfeldt a - Duloxetine (Controls unexposed, NOS), 2021 Stillbirth (> 22 weeks of pregnancy) during pregnancy (anytime or not specified) population based cohort retrospective unexposed (general population or NOS) excluded Adjustment: Yes Monotherapy: no or not specified 1.18 [0.43;3.19]
excluded (control group) 		5/1,581   17/6,324 22 1,581
ref
S11685
R42956		 Ankarfeldt a - Duloxetine (Controls unexposed, sick), 2021 Stillbirth (> 22 weeks of pregnancy) during pregnancy (anytime or not specified) population based cohort retrospective unexposed, sick Adjustment: Yes Monotherapy: no or not specified Unexposed sick: intermediate history of illness/treatment (3-12 months before pregnancy) 0.83 [0.25;2.73] 5/1,559   6/1,561 11 1,559
ref
S11774
R43309		 Richardson - Venlafaxine, 2019 Intrauterine fetal death/stillbirth (after 24 weeks) at least 1st trimester prospective cohort unexposed (general population or NOS) Adjustment: No Matched Monotherapy: no or not specified 1.36 [0.25;5.11] 3/214   12/1,162 15 214
ref
S11776
R43331		 Te Winkel - Venlafaxine, 2016 Stillbirths during pregnancy (anytime or not specified) prospective cohort unexposed (general population or NOS) Adjustment: No Monotherapy: no or not specified 1.65 [0.39;6.94] C 5/732   3/724 8 732
ref
Total 3 studies 1.16 [0.53;2.56] 34 2,505
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 Ankarfeldt a - Duloxetine (Controls unexposed, sick), 2021Ankarfeldt a - Duloxetine, 2021 1 0.83[0.25; 2.73]111,55943%ROB confusion: moderateROB selection: moderateROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: low Richardson - Venlafaxine, 2019Richardson - Venlafaxine, 2019 1.36[0.25; 5.11]1521427%ROB confusion: seriousROB selection: moderateROB classification: moderateROB missing: moderateROB mesure: moderateROB reporting: moderate Te Winkel - Venlafaxine, 2016Te Winkel - Venlafaxine, 2016 1.65[0.39; 6.94]873230%ROB confusion: criticalROB selection: moderateROB classification: moderateROB missing: unclearROB mesure: unclearROB reporting: moderate Total (3 studies) I2 = 0% 1.16[0.53; 2.56]342,5050.25.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Controls unexposed, sick;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.16[0.53; 2.56]342,5050%NAAnkarfeldt a - Duloxetine (Controls unexposed, sick), 2021 Richardson - Venlafaxine, 2019 Te Winkel - Venlafaxine, 2016 3 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.51[0.53; 4.28]239460%NARichardson - Venlafaxine, 2019 Te Winkel - Venlafaxine, 2016 2 unexposed, sickunexposed, sick 0.83[0.25; 2.74]111,559 -NAAnkarfeldt a - Duloxetine (Controls unexposed, sick), 2021 1 Tags Adjustment   - No  - No 1.51[0.53; 4.28]239460%NARichardson - Venlafaxine, 2019 Te Winkel - Venlafaxine, 2016 2   - Yes  - Yes 0.83[0.25; 2.74]111,559 -NAAnkarfeldt a - Duloxetine (Controls unexposed, sick), 2021 1 MatchedMatched 1.36[0.30; 6.21]15214 -NARichardson - Venlafaxine, 2019 1 Monotherapy   - no or not specified  - no or not specified 1.16[0.53; 2.56]342,5050%NAAnkarfeldt a - Duloxetine (Controls unexposed, sick), 2021 Richardson - Venlafaxine, 2019 Te Winkel - Venlafaxine, 2016 3 Unexposed sick   - intermediate history of illness/tre ...  - intermediate history of illness/treatment (3-12 months before pregnancy) 0.83[0.25; 2.74]111,559 -NAAnkarfeldt a - Duloxetine (Controls unexposed, sick), 2021 1 All studiesAll studies 1.16[0.53; 2.56]342,5050%NAAnkarfeldt a - Duloxetine (Controls unexposed, sick), 2021 Richardson - Venlafaxine, 2019 Te Winkel - Venlafaxine, 2016 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 11684

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.33[0.64; 2.73]452,5270%NAAnkarfeldt a - Duloxetine (Controls unexposed, NOS), 2021 Richardson - Venlafaxine, 2019 Te Winkel - Venlafaxine, 2016 3 unexposed, sick controlsunexposed, sick controls 0.83[0.25; 2.74]111,559 -NAAnkarfeldt a - Duloxetine (Controls unexposed, sick), 2021 10.510.01.0