SSRI Birth Defects: A CautionaryTale From the Crib

West Paducah, KTRacine (not her real name pending lawsuit) has a son who was born at just 34 weeks with hypoplastic left heart syndrome (HLHS). She had been taking the antidepressant Effexor (Venlafaxine ) during her pregnancy and now wonders if that may have had something to do with her son's heart defect.

While no one can say for certain whether the Effexor caused Racine's son's HLHS, knowing in advance of pregnancy that problems are possible would have been useful.
HLHS is irreversible, it cannot be cured. Essentially it is a heart defect in which the aorta and left ventricle are very small, and the aortic and mitral valves are also too small, so that the blood flow is insufficient, or they are closed entirely. Needless to say this has serious consequences.

According to information from the American Heart Association, while a baby with HLHS may appear normal at birth, problems will become evident within days of birth. Typically, the baby can become ashen in appearance, and will have difficulties breathing and feeding. Worse, it's usually fatal if left untreated.

A series of operations or a heart transplant are the only available treatments for HLHS. Not a happy set of circumstances for any newborn and his family. And they take on an entirely different light in the knowledge that the situation may have been preventable.
While it's impossible to say what the outcome would have been for her son had Racine known of the potential for SSRI/SNRI birth defects, it can't be stressed enough that the risks are very real, and women need to be made aware of them. The fact is, many women are not.

A study of 500,000 women, published in the Annals of Internal Medicine in 2007, found that 50 percent of women taking a prescription drug during pregnancy were not aware that those drugs could cause birth defects, because they had not been warned about getting pregnant while on the drugs.

SSRI Birth Defects – What Are They?
Selective serotonin reuptake inhibitor (SSRI) birth defects have been compared to birth defects and developmental problems in children exposed to other types of drugs during pregnancy.

According to a study published in the Archives of Pediatric & Adolescent Medicine in 2006, 30 percent of infants who were exposed to antidepressants while in the womb (in utero) experience some withdrawal symptoms. Worse, some 13 percent of those newborns suffer severe withdrawal symptoms, specifically tremors, gastrointestinal problems, respiratory distress, sleep disturbances, and high-pitched crying. A rapid heartbeat, profuse sweating, feeding difficulties, and irritability have also been reported as infant SSRI withdrawal symptoms.

Coincidentally, the Food and Drug Administration (FDA) issued an alert in 2006 on SSRI birth defects which stated, "A recently published case-control study has shown that infants born to mothers who took SSRIs after the 20th week of pregnancy were 6 times more likely to have persistent primary hypertension of the newborn (PPHN) than infants born to mothers who did not take antidepressants during pregnancy." The FDA alert also stated, "Neonatal PPHN is associated with significant morbidity and mortality."

Then, in 2007, a study published in the New England Journal of Medicine showed that the use of antidepressants in the first 3 months of pregnancy more than doubles the risk of and craniosynostosis (premature closure of the connections between the bones of the skull before brain growth is complete), omphalocele (the child's abdomen does not close properly allowing intestines and other organs to protrude outside the body), and anencephaly (birth without forebrain).

Effexor is an SNRI – selective norepinephrine reuptake inhibitor, which is similar but not the same as an SSRI. SNRIs carry the same warnings about use during pregnancy and risk for heart defects as SSRIs. If you're taking it and are thinking of becoming pregnant ask your doctor or health care professional about the possibility of birth defects.