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Major congenital malformations following prenatal exposure to serotonin reuptake inhibitors and benzodiazepines using population-based health data

  1. Tim F. Oberlander1,2,*,
  2. William Warburton2,
  3. Shaila Misri3,
  4. Wayne Riggs4,
  5. Jaafar Aghajanian2,
  6. Clyde Hertzman2

Article first published online: 21 FEB 2008

DOI: 10.1002/bdrb.20144

Issue

Birth Defects Research Part B: Developmental and Reproductive Toxicology

Birth Defects Research Part B: Developmental and Reproductive Toxicology

Volume 83, Issue 1, pages 68–76, February 2008

Additional Information

How to Cite

Oberlander, T. F., Warburton, W., Misri, S., Riggs, W., Aghajanian, J. and Hertzman, C. (2008), Major congenital malformations following prenatal exposure to serotonin reuptake inhibitors and benzodiazepines using population-based health data. Birth Defects Research Part B: Developmental and Reproductive Toxicology, 83: 68–76. doi: 10.1002/bdrb.20144

Author Information

  1. 1

    Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada

  2. 2

    Human Early Learning Partnership, University of British Columbia, Vancouver, BC, Canada

  3. 3

    Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada

  4. 4

    Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada

*FRCPC, Early Human Experience Unit, Centre for Community Child Health Research, Room L408, 4480 Oak St., Vancouver, BC V6H 3V4 Canada

Publication History

  1. Issue published online: 21 FEB 2008
  2. Article first published online: 21 FEB 2008
  3. Manuscript Accepted: 16 DEC 2007
  4. Manuscript Revised: 19 NOV 2007
  5. Manuscript Received: 17 OCT 2007

Funded by

  • BC Ministry of Children and Family Development
  • The Michael Smith Foundation for Health Research

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Keywords:

  • serotonin reuptake inhibitors (SRIs);
  • benzodiazepines (BZs);
  • congenital malformations;
  • prenatal exposure

Abstract

BACKGROUND: To determine a population-based incidence of congenital anomalies following prenatal exposure to serotonin reuptake inhibitor (SRI) antidepressants used alone and in combination with a benzodiazepines (BZ). METHODS: Population health data, maternal health, and prenatal prescription records were linked to neonatal records, representing all live births (British Columbia, Canada, N=119,547) during a 39-month period (1998–2001). The incidence and risk differences (RD) for major congenital anomalies (CA) and congenital heart disease (CHD), including ventricular and atrial septal defects (VSD, ASD), from infants of mothers treated with an SRI alone, a benzodiazepine (BZ) alone, or SRI+BZ in combinationcompared to outcomesno exposure. RESULTS: Risk for a CA or CHD did increase following combined SRI+BZ exposure compared with no exposure. However, using a weighted regression model, controlling for maternal illness characteristics, combination therapy risk remained significantly associated only with CHD. The risk for an ASD was higher following SRI monotherapy compared with no exposure, after adjustment for maternal covariates. Dose/day was not associated with increased risk. CONCLUSIONS: Infants exposed to prenatal SRIs in combination with BZs had a higher a incidence of CHD compared to no exposure, even after controlling for maternal illness characteristics. SRI monotherapy was not associated with an increased risk for major CA, but was associated with an increased incidence of ASD. Risk was not associated with first trimester medication dose/day. Birth Defects Research (Part B) 83:68–76, 2008. © 2008 Wiley-Liss, Inc.

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