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Antidepressants and Pregnancy OK?

But Certain SSRIs May Boost Specific Birth Defect Risks, New Studies Show
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CDC Study Details continued...

The mothers participated in a telephone interview, answering questions about their exposure to antidepressants during pregnancy and one month before. In all, 3% of them, or 408, reported use of SSRIs during pregnancy or one month before they conceived.

The researchers evaluated four SSRIs, including Prozac, Zoloft, Paxil, and Celexa. Overall, no significant associations were found between the mother's use of the SSRIs and congenital heart defects, Reefhuis says. But they did find that Paxil use was linked to one type of heart defect, called right ventricular outflow tract obstruction defect, she says.

And they found an overall association between SSRIs and three other types of birth defects:

  • Anencephaly. A defect in which the neural tube fails to close. The neural tube is a narrow channel that normally closes about the fourth week of pregnancy to form the brain and spinal cord.
  • Craniosynostosis. A defect in which the joints between the bones of the skull close prematurely before brain growth is complete. Mental retardation can occur.
  • Omphalocele. An abdominal wall defect in which intestines and other organs can protrude.

The increased risk ranged from 2.4 to 2.8 times higher, she says. But the numbers of infants affected, in each case, were small, she says. For instance, nine of the 214 born with anencephaly were exposed to SSRIs.

Early Antidepressant Use Study

Louik and her team evaluated birth defects and SSRI use in the first trimester of pregnancy in 9,849 infants with birth defects and 5,860 without, using data from the ongoing Slone Epidemiology Center's Birth Defects Study. "The point was to evaluate specific SSRIs and specific birth defects," she says. "What we found was although we didn't see an increased risk overall for SSRIs, there were some individual SSRIs that increase the risk for specific birth defects."

In contrast to the CDC study, her team did not find an association of a significantly increased overall risk for craniosynostosis, omphalocele, neural tube defects as a group, or overall heart defects. But they did find specific drugs are linked to specific defects.

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