Duloxetine updated on 07-01-2025

Congenital heart defects

id	Study   Auto Ankarfeldt a (Controls unexposed, NOS), 2021Ankarfeldt a (Controls unexposed, sick), 2021Marks (Controls exposed to Bupropion), 2021Huybrechts (Controls unexposed, NOS), 2020Huybrechts (Controls unexposed, sick), 2020	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.
S11682 R42909	Ankarfeldt a (Controls unexposed, NOS), 2021	Heart defects	1st trimester	population based cohort retrospective	unexposed (general population or NOS) excluded	Adjustment: Yes Monotherapy: no or not specified	0.95 [0.63;1.44] excluded (control group)	23/1,430   25,755/1,965,441	25,778	1,430		ref
S11683 R42925	Ankarfeldt a (Controls unexposed, sick), 2021	Heart defects	1st trimester	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)	1.19 [0.70;2.05]	23/1,444   37/2,724	60	1,444		ref
S13147 R50191	Marks (Controls exposed to Bupropion), 2021	Cardiac Malformations	during pregnancy (anytime or not specified) excluded	retrospective cohort	exposed to other treatment, sick	Adjustment: No Monotherapy: substance alone among all Antidep (SSRI, SNRI, ...)	1.36 [0.51;3.66] C excluded (exposition period)	6/139   13/406	19	139		ref
S11747 R43156	Huybrechts (Controls unexposed, NOS), 2020	Cardiovascular anomalies	1st trimester	retrospective cohort (claims database)	unexposed (general population or NOS) excluded	Adjustment: Yes Monotherapy: no or not specified	1.29 [0.99;1.68] excluded (control group)	59/2,532   17,605/1,284,827	17,664	2,532		ref
S11748 R43177	Huybrechts (Controls unexposed, sick), 2020	Cardiovascular anomalies	1st trimester	retrospective cohort (claims database)	unexposed, sick	Adjustment: Yes Monotherapy: no or not specified Unexposed sick: intermediate history of illness/treatment (3-12 months before pregnancy)	1.41 [0.92;2.17]	59/2,532   43/2,456	102	2,532		ref
					Total	2 studies	1.32 [0.94;1.85]		162	3,976
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 11747, 11682

Umbrella review (other published meta-analyses)