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Table 5 Associations between ARM and maternal use of psychiatric drugs

From: Maternal drug use and the risk of anorectal malformations: systematic review and meta-analysis

 

Maternal use of psychiatric drugs

 

Ref.

First author, year

Exposure

ORcrude [95% CI]

ORadj [95% CI]

Adjustment/matching factors

[52]

Furu, 2015

Any SSRI

1.5 [0.95, 2.37]

1.4 [0.88, 2.32]

Maternal age, year of birth, birth order, smoking, maternal diabetes, and country, and use of other prescribed drugs (antiepileptics, anxiolytics and hypnotics, and angiotensin converting enzyme inhibitors)

Sertraline

2.8 [1.33, 5.92]

2.5 [1.09, 5.57]

Citalopram

1.6 [0.70, 3.48]

1.5 [0.64, 3.25]

[50]

Wemakor, 2015

Any SSRI

–

2.5 [1.06, 5.68]

Registry

Fluoxetine

–

2.6 [0.60, 10.91]

Paroxetine

–

2.8 [0.66, 11.96]

Citalopram

–

2.2 [0.29, 16.63]

Sertraline

–

–

Escitalopram

–

6.0 [0.73, 49.62]

[76]

Källén, 2013

Opioids

–

–

–

Anticonvulsants

2.9 [0.96, 6.86]a

–

 

Neurolepticsb

–

–

 

Dixyrazine or prochlorperazine

–

–

 

Sedatives or hypnotics

1.2 [0.33, 3.06]a

–

 

Antidepressants

1.2 [0.66, 2.10]

–

 

[54]

Polen, 2013

Antidepressantsc

–

–

–

Venlafaxinec

–

–

 

[56]

Reis and Källén, 2010

Antidepressants

1.1 [0.40, 2.36]a

–

–

[68]

Alwan, 2007

Any SSRI

1.0 [0.4, 2.0]

0.7 [0.3, 1.8]

Maternal race or ethnic group, presence or absence of maternal obesity, presence or absence of maternal smoking, and family income

[64]

Louik, 2007

Any SSRI

–

1.9 [0.8, 4.3]

Maternal age, maternal race or ethnic group (self-reported), maternal education, year of last menstrual period/study center (a composite variable), parity, first-trimester smoking status, first-trimester alcohol consumption, any family history of a birth defect, history of a cardiac defect in a first-degree relative, prepregnancy body-mass index, seizures, diabetes mellitus, hypertension, infertility, any use of folic acid, and first-trimester use of folic acid

Fluoxetine

–

1.4 [0.3, 6.1]

Paroxetine

–

1.0 [0.1, 7.8]

Citalopram

–

3.0 [0.3, 28.2]

Sertraline

–

4.4 [1.2, 16.4]

Non-SSRI antidepressant

–

2.2 [0.6, 7.8]

[65]

Czeizel, 2003

Diazepam in entire pregnancy

Diazepam in second-third months

of gestation

2.2 [1.2, 3.9]

1.9 [1.1, 3.3]

–

10.0 [1.3, 78.1]

5.2 [1.4, 19.7]

 

[43]

Bonnot, 2001

Lorazepam

–

6.2 [2.44, 15.74]

Maternal age and parity

  1. SSRI selective serotonin reuptake inhibitors
  2. aRisk Ratio (RR)
  3. bNeuroleptics other than dixyrazine or prochloperazine
  4. cOnly one case was exposed to antidepressants