NEW YORK (Reuters Health) Nov 08 - The use of selective serotonin reuptake inhibitors (SSRIs) early in pregnancy seems to moderately raise the risk of congenital malformations in offspring, suggests the results of a Danish population-based cohort study.
"Human data on the teratogenicity of SSRIs are limited," note Dr. Pia Wogelius from Aarhus University Hospital and colleagues in the November issue of Epidemiology.]
During the study period, a reference cohort of 150,780 women who were not prescribed an SSRI gave birth to 5112 (3.4%) children with congenital malformations, whereas 1051 women who filled a prescription for SSRIs any time during early pregnancy gave birth to 51 (4.9%) children with congenital malformations.
The corresponding adjusted relative risk for congenital malformations with maternal SSRI use was 1.34.
The 453 women who filled SSRI prescriptions during the second or third month of pregnancy, when organogenesis mainly takes place, gave birth to 31 (6.8%) children with congenital deformities. The corresponding adjusted relative risk in these women was 1.84.
It's unclear, the authors note, whether the effects were causal or due to factors related to the underlying disease for which SSRIs were prescribed. However, the finding that the association between SSRI use and risk of congenital malformations was stronger during the second or third month of pregnancy is consistent with a causal effect.
"There was no evidence that the association was specific to particular malformations."
Further studies, the team concludes, are needed to confirm these findings and to clarify whether the risk is attributable to SSRIs, to underlying psychiatric disease, or to other confounding factors.