Antidepressants & birth defects?

Published: July 9, 2015

Antidepressants & birth defects?, Some antidepressants may increase the risk of birth defects if taken early in pregnancy, while others don’t seem to pose the same risks, a study finds.

The question of whether antidepressants can cause birth defects has been debated for years, and studies have been all over the map. That makes it hard for women and their doctors to make decisions on managing depression during pregnancy.

To try to untangle the question, researchers at the Centers for Disease Control and Prevention analyzed federal data on more than 38,000 women who gave birth between 1997 and 2009. They looked at the number of birth defects among babies and asked women whether they took any antidepressants in the month before getting pregnant or during the first three months of pregnancy.

The study, published Wednesday in The BMJ, found no association between the most commonly used antidepressant, sertraline (Zoloft), and birth defects. Forty percent of the women who took antidepressants took sertraline.

They also found no increased risk of birth defects with the antidepressants citalopram (Celexa) and escitalopram (Lexapro).

But the analysis did find an association between birth defects and the antidepressants fluoxetine (Prozac) or paroxetine (Paxil). That included heart defects, abdominal wall defects, and missing brain and skull defects with paroxetine, and heart wall defects and irregular skull shape with fluoxetine. The relative risk increased 2 to 3.5 times, depending on the defect and the medication.

That may sound like a lot, but Jennita Reefhuis, an epidemiologist and lead researcher in the study, says “the overall risk is still small.”

For the children of women treated with paroxetine early in pregnancy, the absolute risk of brain and skull malformation (anencephaly) rose from 2 to 7 per 10,000 births. For a heart defect, absolute risk increased from 10 to 24 per 10,000 births.

Because this is an association study, it doesn’t prove that the medications caused birth defects.

Antidepressants & birth defects?


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