Pregnant women who consume antidepressants may have babies with major congenital anomalies

In a recent dose-response analysis, scientists have found that pregnant women who take a specific type of antidepressant in early pregnancy have a small but significantly greater risk of having babies with major congenital anomalies (sometimes referred to as birth defects) or stillbirths compared with those who did not take these antidepressants.

Published in the Plos One journal, the study analyzed data from more than 500,000 infants and found that women, who had been prescribed selective serotonin reuptake inhibitors, known as SSRIs, in the first trimester of pregnancy or 3 months before pregnancy were at a small but significantly greater risk of having infants with congenital anomalies, particularly severe heart defects or stillbirths compared with those who did not take SSRIs.

 

The study found that where SSRIs were not prescribed, 6 in 200 pregnancies had an adverse outcome of stillbirth or a baby with a major congenital anomaly, but when SSRIs were prescribed this rose to 7 in 200.

The team say this risk is of public health importance due to the severity of the outcome and because SSRIs are prescribed to 5.5 percent of pregnant women in Wales, 2.1 percent in Denmark and 1.6 percent in Norway.

Now, the researchers are calling on health care professionals to take the following action:-

-Review all women requesting SSRI prescriptions and not just those who are planning pregnancy.

-Consider women who misuse substances or alcohol as being at higher risk of adverse pregnancy outcomes when prescribed SSRIs

-Evaluate pre-pregnancy care when SSRIs are prescribed

-Consider offering at-risk women enhanced scans to detect serious heart defects

-Ensure that appropriate levels of neonatal care are available to at-risk women at birth

Lead researcher of the study Sue Jordan, said: "To our knowledge, this is the first dose-response analysis that shows the link between SSRI doses and congenital anomalies and stillbirths. While this extra risk may seem small, in my view, the outcomes are as serious as they can be."

Adding, "Women should not stop taking SSRIs without consulting their doctors, and we are not saying stop all medicines, but our message is that we want our health care professionals to be very mindful of this link and to take the appropriate action to ensure that women are given the right type of care before, during and after pregnancy to minimize the risks of congenital anomalies and stillbirths linked to SSRIs.