Antidepressant use during pregnancy and the risk for gestational diabetes: a systematic review and meta-analysis

Figures & data

Table 1. Characteristics of included studies.

Study, year	Location, setting	Study design	Study period	Exposure measurement	Outcome assessment	Total population	Adjustment	Quality
Wen et al. (2006)	Canada, population-based	Cohort	1990–2000	Health databases	ICD-9	Exposed 972 Unexposed 3878	Maternal age, receipt of provincial social assistance, parity, and multigestation	8
Reis et al. (2010)	Sweden, population-based	Cohort	1995–2007	Swedish Medical Birth Register	ICD-9 or ICD-10	Exposed 14,821 Unexposed 1,062,190	Year of birth, maternal age, parity, smoking, and body mass index	8
Dandjinou et al. (2019)	Canada, population-based	Nested case-control	1998–2015	Quebec Prescription Drug Insurance Database	ICD-9 or ICD-10	Exposed 9741 Unexposed 200,214	First day of gestation , receipt of social assistance during pregnancy, physician-based diagnoses of maternal diseases; medication use; history of antidepressant use and health service utilization	9
Wartko et al. (2019)	USA, population-based	Cohort	2001–2014	Pharmacy dispensing data	ICD-9-CM	Exposed 1634 Unexposed 1211	Inverse probability of treatment weighting, using the propensity score	9
Lupattelli et al. (2021)	Norway, population-based	Cohort	1999–2008	Medical Birth Registry of Norway	Glucose Challenge Test	Exposed 891 Unexposed 5756	Inverse probability of treatment weighting, using the propensity score	9

ICD: international classification of diseases.

Figure 1. Flow chart of the studies considered and finally selected for review.

Table 2. Meta-analysis for studies included in the analysis.

Subgroup analysis	Number of studies	Number of estimates	Pooled RR (95% CI), I^2 statistics (%), p-value for the heterogeneity Q test	Model used
Overall	5	5	1.2 (1.11–1.3); I^2 = 0%, p = .643	Fixed effects
Study region
Europe	2	2	1.31 (1.04–1.65); I^2 = 26.3%, p = .244	Fixed effects
North America	3	3	1.19 (1.09–1.29); I^2 = 0%, p = .773	Fixed effects
Antidepressant type
SRI	4	10	1.13 (1.05–1.23); I^2 = 0%, p = .498	Fixed effects
SSRI	2	2	1.09 (0.99–1.19); I^2 = 0%, p = .819	Fixed effects
Venlafaxine	2	2	1.29 (1.11–1.5); I^2 = 0%, p = .546	Fixed effects
Sertraline	2	2	1.09 (0.89–1.32); I^2 = 22%, p = .257	Fixed effects
Fluoxetine	2	2	0.92 (0.69–1.22); I^2 = 0%, p = .578	Fixed effects
Paroxetine	2	2	1.11 (0.93–1.32); I^2 = 0%, p = .429	Fixed effects
Citalopram	2	2	1.08 (0.93–1.25); I^2 = 33.3%, p = .221	Fixed effects
Vs. unexposed pregnancies but with clinical indication	3	3	1.13 (1–1.28); I^2 = 0%, p = .743	Fixed effects

Figure 2. Antidepressant exposure during pregnancy and risk of GDM vs. unexposed general population.

Figure 3. Antidepressant exposure during pregnancy and risk of GDM vs. unexposed with clinical indication.