Document Detail


Risks of congenital malformations and perinatal events among infants exposed to antidepressant medications during pregnancy.
MedLine Citation:
PMID:  17729378     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To evaluate risks for perinatal complications and congenital defects among infants exposed in utero to antidepressants. METHODS: We identified 2201 women who were prescribed an antidepressant during pregnancy and who delivered an infant within one of five large managed care organizations (HMO). Prescription drug dispensings and inpatient and outpatient diagnoses were obtained from automated databases at each HMO. Antidepressants were categorized into tricyclic antidepressants (TCAs) or selective serotonin reuptake inhibitors (SSRIs), and medication timing was assessed by trimester. Rates of congenital anomalies or perinatal complications were compared to infants whose mothers were not prescribed antidepressants during pregnancy. RESULTS: Infants exposed to SSRIs or TCAs during pregnancy had a significant increase in preterm delivery risk. Fullterm infants exposed to SSRIs during the third trimester had an increased risk for respiratory distress syndrome, endocrine and metabolic disturbances, hypoglycemia, temperature regulation disorders, and convulsions. Third-trimester exposure to TCAs was also associated with an increased risk for respiratory distress syndrome, endocrine and metabolic disturbances, and temperature regulation disorders. There were 182 infants exposed to Paroxetine, and these infants did not have an increased risk of cardiac septal defects. CONCLUSIONS: SSRIs and TCAs did not show a consistent link with congenital anomalies. Paroxetine exposure was not linked with an increased risk for cardiovascular anomalies, although our study power to detect a moderate increase in risk was limited. Infants exposed to antidepressants were at increased risk for preterm delivery. Both SSRIs and TCAs used during the third trimester appeared to increase the risk for perinatal complications and their use should be managed carefully among pregnant women with depression.
Authors:
Robert L Davis; David Rubanowice; Heather McPhillips; Marsha A Raebel; Susan E Andrade; David Smith; Marianne Ulcickas Yood; Richard Platt;
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, Non-P.H.S.; Review    
Journal Detail:
Title:  Pharmacoepidemiology and drug safety     Volume:  16     ISSN:  1053-8569     ISO Abbreviation:  Pharmacoepidemiol Drug Saf     Publication Date:  2007 Oct 
Date Detail:
Created Date:  2007-10-08     Completed Date:  2007-11-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9208369     Medline TA:  Pharmacoepidemiol Drug Saf     Country:  England    
Other Details:
Languages:  eng     Pagination:  1086-94     Citation Subset:  IM    
Affiliation:
Center for Health Studies, Group Health Cooperative, Seattle, WA, USA. robert.l.davis@kp.org
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MeSH Terms
Descriptor/Qualifier:
Abnormalities, Drug-Induced / etiology*
Antidepressive Agents / adverse effects*
Antidepressive Agents, Tricyclic / adverse effects
Female
Fetus / drug effects*
Humans
Obstetric Labor, Premature / chemically induced
Pregnancy
Retrospective Studies
Risk
Serotonin Uptake Inhibitors / adverse effects
Grant Support
ID/Acronym/Agency:
HS10391/HS/AHRQ HHS
Chemical
Reg. No./Substance:
0/Antidepressive Agents; 0/Antidepressive Agents, Tricyclic; 0/Serotonin Uptake Inhibitors
Comments/Corrections
Comment In:
Pharmacoepidemiol Drug Saf. 2007 Nov;16(11):1181-3   [PMID:  17966108 ]

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


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