Update of Swedish Study Upholds Concern for SSRI Birth Defects

Linkoping, SwedenSwedish research on maternal use of antidepressants in pregnancy continues to bolster existing concerns about SSRI birth defects, according to a recent issue of Obesity, Fitness & Wellness Week (OFWW). "Concerns have been expressed about possible adverse effects of the use of antidepressant medication during pregnancy, including risk for neonatal pathology and the presence of congenital malformations," according to the authors of the study.

According to the September 18th issue of OFWW, the researchers used data from the Swedish Medical Birth Register from July 1995 through 2007. Women who reported the use of antidepressants in early pregnancy, or were prescribed antidepressants during pregnancy by antenatal care, were identified for the study.

The end number for study purposes was 14,821 women with 15,017 infants.

"Maternal characteristics, maternal delivery diagnoses, infant neonatal diagnoses and the presence of congenital malformations were compared with all other women who gave birth, using the Mantel-Haenszel technique and with adjustments for certain characteristics," the authors noted.

"There was an association between antidepressant treatment and pre-existing diabetes and chronic hypertension, but also with many pregnancy complications. Rates of induced delivery and caesarean section were increased."

The study authors noted that neonatal complications were common, especially with regard to the use of tricyclic (TCA) antidepressant use. "An increased risk of persistent pulmonary hypertension of the newborn (PPHN) was verified. The congenital malformation rate was increased after TCAs," wrote M. Reis and colleagues.

The conclusion?

"Use of TCAs was found to carry a higher risk than other antidepressants, and paroxetine (Aropax, Paxil, Seroxat) seems to be associated with a specific teratogenic property."

Paxil, one of the antidepressants mentioned, is a drug belonging to the SSRI class (selective serotonin reuptake inhibitor) and includes a host of SSRI side effects. One of the most grievous adverse reactions is PPHN, or persistent pulmonary hypertension of the newborn. The latter is considered a serious birth defect.

M. Reis is affiliated with the National Board of Forensic Medicine, Department of Forensic Genetics and Forensic Toxicology, Linkoping, Sweden. The study authored by Reis and colleagues updates a previous study and was published in the Journal of Psychological Medicine, published out of New York.