Document Detail


First trimester paroxetine use and the prevalence of congenital, specifically cardiac, defects: a meta-analysis of epidemiological studies.
MedLine Citation:
PMID:  19739149     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Several studies have evaluated maternal first trimester paroxetine use and the prevalence of congenital defects, particularly cardiac defects. To synthesize current epidemiologic information, a meta-analysis was conducted. METHODS: A systematic literature search was conducted for original research published from January 1, 1992, through September 30, 2008. Results were extracted using predefined criteria, and authors were contacted for additional information when necessary. Compiled results were evaluated for funnel plot asymmetry, heterogeneity, and study characteristic associations. Where appropriate, fixed-effect summary estimates were calculated and sensitivity analyses performed. RESULTS: Twenty reports (11 including results for aggregated congenital and combined cardiac defects, six for aggregated congenital defects only, and three for combined cardiac defects only) met prespecified inclusion criteria. There was little evidence of funnel plot asymmetry or overall heterogeneity. Summary estimates were produced for combined cardiac defects (prevalence odds ratio [POR], 1.46; 95% confidence interval [CI], 1.17-1.82) and aggregated congenital defects (POR, 1.24; 95% CI, 1.08-1.43) and first trimester paroxetine use. Some study characteristics may be associated with differential POR estimates for paroxetine and either combined cardiac or aggregated congenital defects. CONCLUSIONS: This meta-analysis found little evidence of publication bias or overall statistical heterogeneity and only weak evidence of associations with some study characteristics. Although subject to limitations, the summary estimate indicates an increased prevalence of combined cardiac defects with first trimester paroxetine use. The summary estimate also indicates an increased prevalence of aggregated congenital defects with paroxetine; however, this association may be explained, in part, by the increased prevalence of combined cardiac defects.
Authors:
Keele E Wurst; Charles Poole; Sara A Ephross; Andrew F Olshan
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Publication Detail:
Type:  Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Birth defects research. Part A, Clinical and molecular teratology     Volume:  88     ISSN:  1542-0760     ISO Abbreviation:  Birth Defects Res. Part A Clin. Mol. Teratol.     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-03-15     Completed Date:  2010-06-22     Revised Date:  2010-07-22    
Medline Journal Info:
Nlm Unique ID:  101155107     Medline TA:  Birth Defects Res A Clin Mol Teratol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  159-70     Citation Subset:  IM    
Copyright Information:
Copyright 2009 Wiley-Liss, Inc.
Affiliation:
Worldwide Epidemiology, GlaxoSmithKline, Research Triangle Park, North Carolina 27709, USA. keele.e.wurst@gsk.com
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MeSH Terms
Descriptor/Qualifier:
Abnormalities, Drug-Induced / epidemiology,  etiology*
Abnormalities, Multiple / epidemiology,  etiology
Adult
Female
Heart Defects, Congenital / epidemiology,  etiology*
Humans
Odds Ratio
Paroxetine / adverse effects*
Pregnancy
Pregnancy Trimester, First
Serotonin Uptake Inhibitors / adverse effects*
Chemical
Reg. No./Substance:
0/Serotonin Uptake Inhibitors; 61869-08-7/Paroxetine
Comments/Corrections
Comment In:
Birth Defects Res A Clin Mol Teratol. 2010 Mar;88(3):171-4   [PMID:  19950383 ]
Birth Defects Res A Clin Mol Teratol. 2010 Mar;88(3):175-7   [PMID:  20175190 ]
Birth Defects Res A Clin Mol Teratol. 2010 Jul;88(7):588; author reply 589   [PMID:  20602457 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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