Sertraline use during pregnancy and the risk of major malformations

Bérard, Anick; Zhao, Jinping; Sheehy, Odile

doi:10.1016/j.ajog.2015.01.034

Cited by 63 publications

(65 citation statements)

References 33 publications

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“…The current literature demonstrates that septal defects are one of the more common findings identified in SSRI-exposed infants [4-7]. However, the VSDs in our study were in the control population.…”

Section: Discussioncontrasting

confidence: 53%

“…Due to the prevalence of maternal depression and common use of SSRIs during pregnancy, it is important to understand the risk profile of SSRIs on perinatal outcomes to properly advise expectant mothers. Epidemiological studies have described a relationship between SSRI exposure and cardiac malformations [4-8]. However, these studies focus primarily on structural defects, not ventricular size or function.…”

Section: Discussionmentioning

confidence: 99%

“…Multiple subsequent studies have been performed to evaluate this association of SSRI exposure and congenital heart defects. Several studies support a mildly increased risk of septal defects [4-7] with SSRI exposure during pregnancy; however, studies may be affected by methodological weaknesses and confounding variables, including maternal depression [7]. A recent systemic meta-analysis of individual SSRIs suggests paroxetine is the only SSRI associated with an increased risk of cardiac malformations [8].…”

Section: Introductionmentioning

confidence: 99%

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A Prospective Study Evaluating the Effects of SSRI Exposure on Cardiac Size and Function in Newborns

et al. 2019

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Background: Selective serotonin reuptake inhibitors (SSRIs) are antidepressants prescribed in 10% of pregnancies in the USA. We have previously shown in preclinical studies that sertraline exposure impacts cardiomyocyte development, leading to reductions in left ventricular size and cardiac function. Objectives: We hypothesized that in utero SSRI exposure will lead to reduced left ventricular dimensions and cardiac function on echocardiography immediately after birth. Methods: Twenty term infants with and 21 term infants without in utero exposure to SSRIs underwent echocardiograms to assess cardiac size and function. The exclusion criteria for infants were prematurity, small or large for gestational age, any respiratory or cardiovascular support needed after birth, and any major congenital malformation. Results: Infants exposed to in utero SSRIs had significantly reduced right ventricular dimensions in the diastole (controls 1.0 cm [0.86, 1.20], SSRI 0.89 cm [0.730, 1.05], p = 0.03), and left ventricular lengths in the diastole and systole (diastole: controls 3.4 cm [3.25, 3.65], SSRI 3.25 cm [3.10, 3.45], p = 0.03; systole: controls 2.9 cm [2.65, 3.05], SSRI 2.6 cm [2.50, 2.85], p = 0.01). No differences were observed in cardiac function. Importantly, there were no differences in maternal conditions or infant birth weight, body surface area, or gestational age. Conclusions: Our findings suggest an association between in utero exposure to SSRIs and ventricular size in infants. Given the increasing use of SSRIs during pregnancy and the importance of early life programming on future cardiovascular health, larger studies need to be completed to determine if in utero SSRI exposure impacts ventricular size.

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Section: Discussioncontrasting

confidence: 53%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A Prospective Study Evaluating the Effects of SSRI Exposure on Cardiac Size and Function in Newborns

et al. 2019

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“…Since then, several population-based studies reported a small yet significant increase in the magnitude of risk for cardiac anomalies with maternal paroxetine use (Bakker et al, 2010;Reis and Kallen, 2010;Wurst et al, 2010;Malm et al, 2011) or other SSRIs (Wogelius et al, 2006;Oberlander et al, 2008;Pedersen et al, 2009;Merlob et al, 2009;Kornum et al, 2010;Malm et al, 2011;JimenezSolem et al, 2012;Berard et al, 2015).…”

Section: Antidepressant Medication Use During Pregnancy and Birth Defmentioning

confidence: 98%

Findings from the National Birth Defects Prevention Study: Interpretation and translation for the clinician

Alwan

Chambers

2015

Birth Defects Research

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“…On the other hand, in a population-based cohort study, in which the safety of sertraline use in the first trimester of pregnancy was analysed based on the data collected from 18.5 thousand women, it was demonstrated that the risk of giving birth to a child with atrial or ventricular septal defect increased by 34%, and the risk of craniosynostosis doubled [22].…”

Section: Antidepressant Use and The Risk Of Congenital Anomaliesmentioning

confidence: 99%

Effect of antidepressants use in pregnancy on foetus development and adverse effects in newborns

2017

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Over the last few years, several reports on the safety of antidepressants use in pregnancy have been published. Studies concerning the adverse effects of exposure to selective serotonin reuptake inhibitors (SSRI) during pregnancy on the developing foetus have indicated an increased risk of various congenital malformations and untoward effects such as poor neonatal adaptation syndrome or persistent pulmonary hypertension, but there still remain inconsistencies between various study results. This paper aims at reviewing the literature on the risks of exposure to antidepressants during pregnancy. SSRIs are generally considered as first-line antidepressant treatment in pregnancy, as they are generally safe and effective. To minimize the teratogenic risks, pregnant women should receive the minimal effective dose of the medication. Depression during pregnancy must not be left untreated, and it should also be remembered that the condition may extend into the postpartum period.

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Sertraline use during pregnancy and the risk of major malformations

Cited by 63 publications

References 33 publications

A Prospective Study Evaluating the Effects of SSRI Exposure on Cardiac Size and Function in Newborns

A Prospective Study Evaluating the Effects of SSRI Exposure on Cardiac Size and Function in Newborns

Findings from the National Birth Defects Prevention Study: Interpretation and translation for the clinician

Effect of antidepressants use in pregnancy on foetus development and adverse effects in newborns

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