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Early Pregnancy Use of SSRIs and Congenital Defects Studied

Last Updated: September 25, 2009.

The use of certain selective serotonin reuptake inhibitors in early pregnancy is associated with a higher prevalence of septal heart defects in offspring, according to research published online Sept. 23 in BMJ.

FRIDAY, Sept. 25 (HealthDay News) -- The use of certain selective serotonin reuptake inhibitors (SSRIs) in early pregnancy is associated with a higher prevalence of septal heart defects in offspring, according to research published online Sept. 23 in BMJ.

Lars Henning Pedersen, M.D., of Aarhus University in Denmark, and colleagues analyzed data from 493,113 children born in Denmark from 1996 to 2003, assessing national records on children diagnosed with malformations in the first year and women who filled a prescription for an SSRI at least twice in early pregnancy or the month before conception.

The researchers found that SSRI use was associated with septal heart defects (odds ratio, 1.99). Individually, sertraline and citalopram were associated with septal heart defects (odds ratios, 3.25 and 2.52, respectively), but paroxetine and fluoxetine were not. A higher risk was seen in women who filled more than one type of SSRI prescription (odds ratio, 4.70)

"If an increased risk for major congenital malformations does exist, this study and others suggest that the absolute risk for the individual pregnant woman is very low. Furthermore, each of the more commonly used drugs in this class has been implicated in at least one study, so it is difficult to conclude that one SSRI is 'safer' than another," writes the author of an accompanying editorial. "Women should be informed about the possible risks and benefits of their treatment choices, and ongoing consultation between the patient's obstetrician and psychiatrist is needed during pregnancy, to determine and carry out the most appropriate and acceptable treatment plan."

The study was funded by a foundation that is supported by the pharmaceutical company Lundbeck. The editorial author reported financial relationships with a variety of companies, some of which make or distribute SSRIs.

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