Table 3.

Summary risk estimates of the association between sertraline use and congenital anomalies

	No. of study	Summary OR 95% CI	I 2 (%)	P*	P** a
Cardiovascular‐related malformation	12	1.36 (1.06–1.74)	64.4	0.01
Atrial and/or ventricular septal defect	8	1.36 (1.06–1.76)	62.2	<0.01
Cardiac malformation	5	1.20 (0.94–1.53)	59.2	0.04
Nervous system	5	1.39 (0.83–2.32)	0.0	0.95
Digestive system	5	1.23 (0.76–1.98)	0.0	0.81
Eye, ear, face and neck	3	1.08 (0.33–3.55)	32.1	0.22
Urogenital system	5	1.03 (0.73–1.46)	0.0	0.76
Musuloskeletal system	5	0.97 (0.69–1.36)	0.0	0.72
Subgroup analysis a
Geographic location					0.53
North America	3	1.26 (1.06–1.49)	0.0	0.91
Europe	7	1.35 (0.88–2.06)	77.2	<0.01
Others	2	2.83 (0.66–12.08)	52.8	0.15
Adjustment for potential confounders
Age					0.68
Yes	8	1.32 (0.91–1.91)	73.4	<0.01
No	4	1.43 (0.98–2.07)	30.6	0.23
Socioeconomic status					0.32
Yes	2	1.84 (0.80–4.24)	78.8	0.03
No	10	1.23 (0.98–1.56)	51.9	0.03
Smoking or alcohol drinking					0.88
Yes	6	1.36 (0.87–2.11)	81.0	<0.01
No	6	1.30 (1.11–1.53)	0.0	0.48
Pregnancy body mass index					0.86
Yes	1	1.52 (0.78–2.96)	N/A	N/A
No	11	1.35 (1.03–1.75)	67.3	<0.01
Pregnancy complications					0.21
Yes	4	1.10 (0.87–1.38)	14.3	0.32
No	8	1.62 (1.09–2.42)	70.4	<0.01
Parity					0.77
Yes	6	1.32 (0.81–2.15)	80.7	<0.01
No	6	1.31 (1.12–1.53)	0.0	0.46

CI, confidence interval; N/A, not available; OR, odd ratio

P* for heterogeneity within each subgroup

P** for heterogeneity between subgroups with metaregression analysis

^aSubgroup analyses were only carried out for cardiovascular‐related malformation