Mom's SSRI Use May Raise Risk of Birth Defects

Reuters -- UK
November 8, 2006

NEW YORK (Reuters Health) - The use of selective serotonin reuptake inhibitor (SSRI) antidepressant drugs early in pregnancy seems to moderately raise the risk of congenital malformations in offspring, suggests the results of a Danish population-based cohort study.

"Human data on the teratogenicity of SSRIs are limited," note Dr. Pia Wogelius from Aarhus University Hospital and colleagues in the November issue of Epidemiology.

During the study period, a reference cohort of 150,780 women who were not prescribed an SSRI gave birth to 5112 (3.4 percent) children with congenital malformations, whereas 1051 women who filled a prescription for SSRIs any time during early pregnancy gave birth to 51 (4.9 percent) children with congenital malformations.

Therefore, women who used an SSRI during pregnancy had a 34 percent higher relative risk of delivering an infant with a congenital malformation compared with those that did not.

The 453 women who filled SSRI prescriptions during the second or third month of pregnancy, a key time for "organogenesis," gave birth to 31 (6.8 percent) children with congenital deformities. These women had an 84 percent higher relative risk of having an infant with a congenital malformation.

It's unclear, the authors note, whether the effects of SSRI use were causal or due to factors related to the underlying disease for which SSRIs were prescribed. However, the finding that the association between SSRI use and risk of congenital malformations was stronger during the second or third month of pregnancy is consistent with a causal effect.

"There was no evidence that the association was specific to particular malformations."

Further studies, the team concludes, are needed to confirm these findings and to clarify whether the risk is attributable to SSRIs, to underlying psychiatric disease, or to other confounding factors.

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