A population-based, case-control study found some associations between maternal antidepressant use and specific birth defects, according to an article published in JAMA Psychiatry.
The analysis included 30,630 mothers of infants with birth defects and 11,478 control mothers, who were asked about the use of citalopram, fluoxetine, paroxetine, sertraline, venlafaxine, and bupropion during the three months before conception or during pregnancy. Early pregnancy exposure was defined as maternal report of using one or more of these medications in any dose, duration, or frequency from the month before conception through the third pregnancy month.
Early pregnancy antidepressant use was reported by 1,562 case mothers (5.1%), and 467 control mothers (4.1%), for whom elevated adjusted odds ratios were observed for individual selective serotonin reuptake inhibitors (SSRIs) and selected congenital heart defects (CHD). This pattern was observed for many SSRI-CHD combinations. Venlafaxine had elevated associations with multiple defects that persisted after partially accounting for underlying conditions.
These findings suggest varied risks for specific birth defects after early pregnancy use of individual SSRIs, venlafaxine, and bupropion, which underscores the importance of risk assessment and a careful balance between proposed interventions versus untreated depression or anxiety.