Sertraline use during pregnancy and effect on fetal cardiac function

Fetal Congenital Cardiac and Vascular Disorders Associated with Sertraline Treatment during Pregnancy: Analysis of FAERS Data

“…The vast majority of the 69 adverse reactions significantly related to sertraline intrauterine exposure were structural abnormalities of fetal cardiovascular system, of which 38 were strongly significantly associated with, except that “trisomy 21” was not related to cardiovascular system; the other 31 were adverse reactions of cardiovascular system, which were structural malformations. The above results from the real-world analysis of FAERS have also been more accurately verified by echocardiography in the studies performed by Ansah et al [ 29 ] and Kolding et al [ 30 ]. The cardiac function of fetuses without cardiac structural malformation exposed to sertraline was evaluated; the results of both studies showed that sertraline intrauterine exposure did not cause changes in fetal cardiac function under the premise of no structural malformations.…”

Antenatal Antidepressant Prescription Associated With Reduced Fetal Femur Length but Not Estimated Fetal Weight

“…In addition, the use of a comparison group of women with psychiatric diagnoses improved study rigor over previous studies, which used pregnant women without psychiatric diagnoses as their comparison groups. 20,66,72 In conclusion, our ultrasonographic evidence suggests that antenatal antidepressant prescription is not associated with fetal global growth, although in a subgroup of fetuses reduced FL may be observed. Future studies should examine the potential clinical implications of reduced FL on newborn and infant health outcomes.…”

“…This is in alignment with a previous study that reported no differences in EFW between fetuses of sertraline-treated women and healthy controls without psychiatric diagnoses. 20 Likewise, birth weight of newborns with antenatal SSRI exposure did not differ from newborns of antidepressant-free women with major depression. 23 Contrasting our findings, the largest available meta-analysis reported an association between exposure to SSRIs and suboptimal fetal growth 9 ; nevertheless, the authors suggested caution when interpreting their results as they did not account for confounders.…”

“…Including a control group without psychiatric disease, another echocardiography study reported smaller right ventricular dimensions during diastole in newborns exposed to SSRIs compared with nonexposed 19 . Indirectly contrasting this evidence, a study using modern ultrasound technology reported no differences between fetuses of sertraline-treated pregnant women and women without psychiatric disease with regard to myocardial performance or fetal weight 20 …”

“…19 Indirectly contrasting this evidence, a study using modern ultrasound technology reported no differences between fetuses of sertraline-treated pregnant women and women without psychiatric disease with regard to myocardial performance or fetal weight. 20 The potentially important effects of maternal psychiatric disease on fetal growth, apart from potential antidepressant effects, have also been highlighted. 21,22 Untreated maternal psychiatric illness is an important confounder, and thus, the use of healthy pregnant women as controls may be not methodologically sound.…”