Original Research Article
Antidepressant Use During Early Pregnancy and the Risk of Congenital Anomalies
Article first published online: 6 JUN 2013
© 2013 Pharmacotherapy Publications, Inc
Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy
Volume 33, Issue 7, pages 693–700, July 2013
How to Cite
(Pharmacotherapy 2013;33(7):693–700) doi: 10.1002/phar.1211
- Issue published online: 1 JUL 2013
- Article first published online: 6 JUN 2013
- congenital anomalies;
- prevalence rates;
- relative risk
To estimate and compare the prevalence of congenital anomalies among the offspring of women exposed and not exposed to antidepressants during early pregnancy.
Matched cohort study.
United Kingdom's General Practice Research Database.
Women exposed to tricyclic and selective serotonin reuptake inhibitor (SSRI) antidepressants during the first trimester of pregnancy (3276 women) and a sample of women matched in a 2:1 ratio who had no exposure to any antidepressant during the first trimester of pregnancy (6617 women).
Measurements and Main Results
The prevalence of any congenital anomaly was 31.0 (95% confidence interval [CI] 27.0–35.5) per 1000 pregnancies among women not exposed to antidepressants and 27.2 (95% CI 22.1–33.4) per 1000 pregnancies among women exposed to antidepressants. The relative risk of having a child with an anomaly in mothers who were exposed to tricyclics and SSRIs during the first trimester compared with mothers not exposed to these drugs was 0.9 (95% CI 0.7–1.1). The relative risks for any anomaly among women exposed to antidepressants were 0.9 (95% CI 0.6–1.2) for tricylics and 0.9 (95% CI 0.7–1.2) for SSRIs. We found no statistically significant, stable increases in the risk of specific anomaly subtypes among women exposed to these antidepressants; however, the number of exposed cases was small.
Exposure to tricyclics and SSRIs during the first trimester of pregnancy was not associated with a statistically significant increased risk of congenital anomalies in the offspring of mothers exposed to these drugs.