Selective serotonin reuptake inhibitor use during early pregnancy and congenital malformations: a systematic review and meta-analysis of cohort studies of more than 9 million births

Gao, Shan‐Yan; Wu, Qi‐Jun; Sun, Cheng‐Hang; Zhang, Tie-Ning; Shen, Zi-Qi; Liu, Caixia; Gong, Ting-Ting; Xu, Xin; Ji, Chao; Huang, Donghui; Chang, Qing; Zhao, Yuhong

doi:10.1186/s12916-018-1193-5

Cited by 106 publications

(84 citation statements)

References 82 publications

(178 reference statements)

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“…With respect to SSRIs, database studies that have not controlled for maternal depression have reported an increased risk of cardiac septal defects in neonates exposed to SSRIs in utero (Gao et al, 2018;Kallen and Otterblad, 2007;Shen et al, 2017), but for the majority of SSRIs this effect is no longer statistically significant when maternal depression (Gao et al, 2018;Huybrechts et al, 2014) and lifestyle risk factors are controlled for (Huybrechts et al, 2014); data relating to sertraline are insufficient to allow an effect to be excluded (Gao et al, 2018).…”

Section: Selective Serotonin Reuptake Inhibitor (Ssri) Antidepressantmentioning

confidence: 99%

Evidence-based guidelines for the pharmacological treatment of schizophrenia: Updated recommendations from the British Association for Psychopharmacology

2019

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These updated guidelines from the British Association for Psychopharmacology replace the original version published in 2011. They address the scope and targets of pharmacological treatment for schizophrenia. A consensus meeting was held in 2017, involving experts in schizophrenia and its treatment.They were asked to review key areas and consider the strength of the evidence on the risk-benefit balance of pharmacological interventions and the clinical implications, with an emphasis on meta-analyses, systematic reviews and randomised controlled trials where available, plus updates on current clinical practice. The guidelines cover the pharmacological management and treatment of schizophrenia across the various stages of the illness, including first-episode, relapse prevention, and illness that has proved refractory to standard treatment. It is hoped that the practice recommendations presented will support clinical decision making for practitioners, serve as a source of information for patients and carers, and inform quality improvement.

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Section: Selective Serotonin Reuptake Inhibitor (Ssri) Antidepressantmentioning

confidence: 99%

Evidence-based guidelines for the pharmacological treatment of schizophrenia: Updated recommendations from the British Association for Psychopharmacology

2019

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“…Selective serotonin reuptake inhibitors (SSRIs) are the most widely prescribed secondgeneration antidepressant drugs. These drugs have also been implicated in a small increased risk of offspring CHD (Bérard et al 2017;Gao et al 2018). However, this is somewhat controversial, as this association may disappear when corrected for confounding factors (Huybrechts et al 2014).…”

Section: Antidepressantsmentioning

confidence: 99%

Environmental Risk Factors for Congenital Heart Disease

Kalisch-Smith

Ved

Sparrow

2019

Cold Spring Harb Perspect Biol

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Congenital heart disease (CHD) has many forms and a wide range of causes. Clinically, it is important to understand the causes. This allows estimation of recurrence rate, guides treatment options, and may also be used to formulate public health advice to reduce the population prevalence of CHD. The recent advent of sophisticated genetic and genomic methods has led to the identification of more than 100 genes associated with CHD. However, despite these great strides, to date only one-third of CHD cases have been shown to have a simple genetic cause. This is because CHD can also be caused by oligogenic factors, environmental factors, and/or gene-environment interaction. Although solid evidence for environmental causes of CHD have been available for almost 80 years, it is only very recently that the molecular mechanisms for these risk factors have begun to be investigated. In this review, we describe the most important environmental CHD risk factors, and what is known about how they cause CHD.

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“…This may have occurred because in 2005, the FDA cautioned that exposure to paroxetine during the first trimester of pregnancy may increase the risk of cardiac malformations [38]; this information was not divulged in Japan. Recently, a meta-analysis study reported a generally small risk of congenital malformations of selective serotonin reuptake inhibitors in pregnancy [39]. Although the OR of Cong in class 6, which included antiepileptic drugs with multiple medications, was higher than 1 in both datasets, it was not higher than that of class 1.…”

Section: Discussionmentioning

confidence: 89%

Adverse event reports in patients taking psychiatric medication during pregnancy from spontaneous reports in Japan and the United States: an approach using latent class analysis

et al. 2020

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Background: Little is known regarding the association between adverse events (AEs) and psychiatric medications administered to pregnant women in clinical trials during the pre-marketing period. This study analyzes reports of AE association with psychiatric medication administrated during pregnancy using post-marketing spontaneous reports of AE from the Japanese Adverse Drug Event Report (JADER) database and Food and Drug Administration Adverse Event Reporting System in the United States (FAERS-US). Methods: We summarized AE reports of psychiatric medication administrated during pregnancy by comparing data obtained from JADER and FAERS-US databases with medication patterns determined as classes via latent class analysis. The odds ratios (ORs) of AE reports categorized into system organ classes in which each class was compared with those without psychiatric medications. Results: The proportions of AE reports under psychiatric medication in pregnancy among all AE reports were 22.0% and 16.6% in JADER and FAERS-US, respectively. The 10,389 reports of psychiatric medication during pregnancy were classified into 11 classes. The proportion of patients receiving four or more psychiatric drugs in JADER was larger than that in FAERS-US. The maximum number of reports in combinations of AE and medication pattern in JADER was 169, for 'general disorders and administration site conditions' from the class of four or more medications (OR = 9.1), while that in FAERS-US was 1,654, for 'injury, poisoning, and procedural complications' from the class of single psychiatric medication (OR = 2.8).

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Selective serotonin reuptake inhibitor use during early pregnancy and congenital malformations: a systematic review and meta-analysis of cohort studies of more than 9 million births

Cited by 106 publications

References 82 publications

Evidence-based guidelines for the pharmacological treatment of schizophrenia: Updated recommendations from the British Association for Psychopharmacology

Evidence-based guidelines for the pharmacological treatment of schizophrenia: Updated recommendations from the British Association for Psychopharmacology

Environmental Risk Factors for Congenital Heart Disease

Adverse event reports in patients taking psychiatric medication during pregnancy from spontaneous reports in Japan and the United States: an approach using latent class analysis

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