Use of selective serotonin-reuptake inhibitors in pregnancy and the risk of birth defects

Sura Alwan; Jennita Reefhuis; Sonja A Rasmussen; Richard S Olney; Jan M Friedman; National Birth Defects Prevention Study

doi:10.1056/NEJMoa066584

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Use of selective serotonin-reuptake inhibitors in pregnancy and the risk of birth defects

Journal article

Open access

Peer reviewed

Use of selective serotonin-reuptake inhibitors in pregnancy and the risk of birth defects

Sura Alwan, Jennita Reefhuis, Sonja A Rasmussen, Richard S Olney, Jan M Friedman and National Birth Defects Prevention Study

The New England journal of medicine, Vol.356(26), pp.2684-2692

2007

DOI: 10.1056/NEJMoa066584

PMID: 17596602

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Abstract

BACKGROUND Information regarding the safety of selective serotonin-reuptake inhibitors (SSRIs) in human pregnancy is sparse. Concern has been raised about the risk of congenital heart defects associated with the use of SSRIs in pregnancy. METHODS We obtained data on 9622 case infants with major birth defects and 4092 control infants born from 1997 through 2002 from the National Birth Defects Prevention Study. Case infants were ascertained through birth-defects surveillance systems in eight U.S. states; controls were selected randomly from the same geographic areas. Mothers completed a standardized telephone interview regarding exposure to potential risk factors, including medications, before and during pregnancy. Exposure to SSRIs was defined as treatment with any SSRI from 1 month before to 3 months after conception. Birth defects were assigned to 26 categories and subcategories. RESULTS There were no significant associations between maternal use of SSRIs overall during early pregnancy and congenital heart defects or most other categories or subcategories of birth defects. Maternal SSRI use was associated with anencephaly (214 infants, 9 exposed; adjusted odds ratio, 2.4; 95% confidence interval [CI], 1.1 to 5.1), craniosynostosis (432 infants, 24 exposed; adjusted odds ratio, 2.5; 95% CI, 1.5 to 4.0), and omphalocele (181 infants, 11 exposed; adjusted odds ratio, 2.8; 95% CI, 1.3 to 5.7). CONCLUSIONS Maternal use of SSRIs during early pregnancy was not associated with significantly increased risks of congenital heart defects or of most other categories of birth defects. Associations were observed between SSRI use and three types of birth defects, but the absolute risks were small, and these observations require confirmation by other studies.

Epidemiology

Biological and medical sciences

General aspects

Medical sciences

Public health. Hygiene

Public health. Hygiene-occupational medicine

Details

Title: Subtitle: Use of selective serotonin-reuptake inhibitors in pregnancy and the risk of birth defects
Creators: Sura Alwan - Department of Medical Genetics, University of British Columbia, Vancouver, BC, Canada
Jennita Reefhuis - National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, United States
Sonja A Rasmussen - National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, United States
Richard S Olney - National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, United States
Jan M Friedman - Department of Medical Genetics, University of British Columbia, Vancouver, BC, Canada
National Birth Defects Prevention Study
Contributors: Paul A Romitti (Contributor) - University of Iowa, Epidemiology
Resource Type: Journal article
Publication Details: The New England journal of medicine, Vol.356(26), pp.2684-2692
DOI: 10.1056/NEJMoa066584
PMID: 17596602
NLM abbreviation: N Engl J Med
ISSN: 0028-4793
eISSN: 1533-4406
Publisher: Massachusetts Medical Society
Language: English
Date published: 2007
Academic Unit: Epidemiology; Biostatistics
Record Identifier: 9984214677502771

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