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Review: adverse effects of antidepressants use during pregnancy

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Question

Question

What are the adverse effects of antidepressant medication during pregnancy?

Outcomes

Congenital malformations, pregnancy outcomes (spontaneous abortion, preterm birth, abnormal birth weight), neonatal outcomes (neonatal adaptation, persistent pulmonary hypertension of the newborn), longer term developmental outcomes.

Methods

Design

Systematic review.

Data sources

MEDLINE, PsycINFO, EMBASE. Hand searching of specific journals and backwards citations from reference lists.

Study selection and analysis

Human studies published in English between 1950 and May 2009. The search was not limited by study design although case series and case reports were only included in the absence of more rigorous evidence. Trial data are mostly lacking.

Main results

A range of studies were found which assessed different adverse effects associated with the use of antidepressants in pregnancy, but many of these had design limitations. Different designs and the number of studies findings positive results are described in the table 1 below.

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Table 1

Summary table of studies

In total, 35 studies examined congenital malformations. One of the four meta-analyses found that first trimester paroxetine was associated with increased risk of major congenital …

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