The study included 18,487 depressed women in the Quebec Pregnancy Cohort, a longitudinal, population-based grouping of 289,688 pregnancies recorded between 1998 to 2009. Of the women studied, 3,640 – about 20% – took antidepressants in the first three months.
Antidepressant classes (selective serotonin reuptake inhibitors (SSRI), serotonin–norepinephrine reuptake inhibitors (SNRI), tricyclic antidepressants (TCA) and other antidepressants) were compared with non-exposure during the first trimester (depressed untreated) and major congenital malformations overall and organ-specific malformations in the first year of life were identified.
Only citalopram increased the risk of major congenital malformations, but antidepressants with serotonin reuptake inhibition effect – SSRIs, SNRIs andamitriptyline (the most used TCA) – increased the risk of certain organ-specific defects: paroxetine increased the risk of cardiac defects and ventricular/atrial septal defects; citalopram increased the risk of musculoskeletal defects and craniosynostosis); TCAs were associated with eye, ear, face and neck defects, and digestive defects; and venlafaxine was associated with respiratory defects.
Full reference: Bérard A, Zhao J-P, Sheehy O. Antidepressant use during pregnancy and the risk of major congenital malformations in a cohort of depressed pregnant women: an updated analysis of the Quebec Pregnancy Cohort. BMJ Open, January 2017