This site is intended for Healthcare Professionals only

SSRIs linked to seven birth defects

Clinical bookmark icon off

SSRIs linked to seven birth defects

Previous studies assessing links between selective serotonin reuptake inhibitors (SSRIs) and birth defects reported inconsistent results.

Now new research, combining published results with data from the National Birth Defects Prevention Study in the US, has confirmed a link between using certain SSRIs in early pregnancy and seven types of birth defects. The researchers assessed the use of citalopram, escitalopram, fluoxetine, paroxetine or sertraline by 17,952 and 9,857 mothers of infants with and without birth defects respectively.

Mothers took the SSRIs between the month before conception to the third month of pregnancy. The analysis adjusted for maternal race or ethnicity, education, smoking and obesity before pregnancy. No evidence emerged supporting nine of the 14 categories of birth defect that previous studies associated with SSRIs.

Nor did the analysis confirm any of the five types of birth defect previously linked to sertraline (the most commonly used SSRI). Anencephaly (absence of parts of the brain and skull) and omphalocele (organs outside the abdomen covered in a thin sack) were found to be 3.2 and 3.5 times commoner respectively in infants born to women taking paroxetine than controls.

Paroxetine was also linked to atrial septal defects (odds ratio [OR] 1.8), right ventricular outflow tract obstruction defects (OR 2.4) and gastroschisis (intestines outside the body; OR 2.5). Right ventricular outflow tract obstruction defects (OR 2.0) and craniosynostosis (baby’s skull bones join prematurely; OR 1.9) were twice as common among infants born to women taking fluoxetine in early pregnancy than controls.

The absolute risk, however, is low. For example, taking paroxetine in early pregnancy increases the risk of anencephaly from two per 10,000 to seven per 10,000. The risk of right ventricular outflow tract obstruction cardiac defects rises from 10 to 24 per 10,000. (BMJ 2015; 350:h3190)

Copy Link copy link button

Clinical

Let’s get clinical. Follow the links below to find out more about the latest clinical insight in community pharmacy.

Share: