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Specific SSRIs and birth defects: interpreting new data in the context of previous reports

Read the full open access research: http://www.bmj.com/content/351/bmj.h3190 The association between maternal use of antidepressants, especially selective serotonin reuptake inhibitors (SSRIs), during pregnancy and birth defects in the infants has been the topic of much discussion in recent years. After initial reports of an association between paroxetine and heart defects, the US Food and Drug Administration published an advisory warning of this potential association in December 2005. Recent meta-analyses and systematic reviews combining data from more than 20 epidemiological studies have reached conflicting conclusions and this uncertainty influences perceptions of the safety of antidepressant use in pregnancy. In this study, the authors set out to follow up on previously reported associations between periconceptional use of selective serotonin reuptake inhibitors (SSRIs) and specific birth defects using an expanded dataset from the National Birth Defects Prevention Study. They conclude that these data provide reassuring evidence for some SSRIs but suggest that some birth defects occur 2-3.5 times more frequently among the infants of women treated with paroxetine or fluoxetine early in pregnancy.