ORCID Profile
0000-0001-5887-2125
Current Organisation
University of South Australia
Does something not look right? The information on this page has been harvested from data sources that may not be up to date. We continue to work with information providers to improve coverage and quality. To report an issue, use the Feedback Form.
Publisher: Cold Spring Harbor Laboratory
Date: 27-02-2020
DOI: 10.1101/2020.02.24.20027532
Abstract: Antidepressant use during the first trimester is reported in 4% to 8% of pregnancies. The use of some selective serotonin reuptake inhibitors (SSRI) during this stage of gestation has been identified as increasing the odds for congenital heart defects, however little is known about the safety of non-SSRI antidepressants. To assess the odds of congenital heart defects associated with the use of any antidepressant during the first trimester of pregnancy. To investigate in idual classes of antidepressants: SSRIs, serotonin norepinephrine reuptake inhibitors (SNRI), tricyclic antidepressants (TCA) and in idual antidepressants. PubMed and Embase were searched without restrictions from inception till 2 January 2020. Prospective and retrospective cohort and case-control studies were included if they documented the maternal usage of antidepressants during the first trimester of pregnancy and assessed the presence of congenital heart defects. Data were extracted by two independent reviewers and the endpoint assessed was congenital heart defects. Where studies reported multiple results for different types of heart defects or in idual antidepressants, results were combined when possible. Analyses assessing in idual antidepressants and classes of antidepressants (SSRIs, SNRIs and TCAs) were undertaken. A total of 16 studies were identified, encompassing 4,564,798 pregnancy outcomes. The odds ratio for maternal use of any antidepressant and the presence of congenital heart defects from the mixed-methods meta-analysis was 1.22 (95% confidence interval (CI): 1.11 to 1.33). Analyses of antidepressants by class produced an odds ratio of 1.50 (95% CI: 1.19 to 1.89) for maternal SNRI use during the first trimester of pregnancy and the formation of congenital heart defects. A significant odds ratio of 1.22 (95% CI: 1.12 to 1.33) was reported for SSRIs. For the TCA class, no increased odds ratio was found. Analyses of in idual antidepressants produced significant odds ratios of 1.53 (95% CI: 1.25 to 1.88), 1.28 (95% CI: 1.01 to 1.62), 1.28 (95% CI: 1.14 to 1.45) and 1.23 (95% CI: 1.01 to 1.50) for paroxetine, fluoxetine, sertraline and bupropion respectively. While some insight has been gained into which classes of antidepressant and in idual antidepressants pose more risk than others for causing congenital heart defects, information regarding some antidepressants is still lacking.
Publisher: Springer Science and Business Media LLC
Date: 22-12-2021
DOI: 10.1007/S40264-020-01027-X
Abstract: Antidepressant use during the first trimester is reported in 4-8% of pregnancies. The use of some selective serotonin reuptake inhibitors during the first trimester has been identified as increasing the odds for congenital heart defects however, little is known about the safety of non-selective serotonin reuptake inhibitor antidepressants. The objective of this study was to assess the odds of congenital heart defects associated with the use of antidepressants during the first trimester of pregnancy, and to update the literature as newer studies have been published since the latest systematic literature review and meta-analysis. PubMed and Embase were searched till 3 June, 2020. Study quality was assessed, and study details were extracted. Meta-analyses were performed using RevMan 5.4, which assessed: (1) any antidepressant usage (2) classes of antidepressants and (3) in idual antidepressants. Twenty studies were identified, encompassing 5,337,223 pregnancies. The odds ratio for maternal use of any antidepressant during the first trimester of pregnancy and the presence of congenital heart defects from the random effects meta-analysis was 1.28 (95% confidence interval [CI] 1.17-1.41). Significant odds ratios of 1.69 (95% CI 1.37-2.10) and 1.25 (95% CI 1.15-1.37) were reported for serotonin norepinephrine reuptake inhibitors and selective serotonin reuptake inhibitors, respectively. A non-statistically significant odds ratio of 1.02 (95% CI 0.82-1.25) was reported for the tricyclic antidepressants. Analyses of in idual SSRIs produced significant odds ratios of 1.57 (95% CI 1.25-1.97), 1.36 (95% CI 1.08-1.72), and 1.29 (95% CI 1.14-1.45) for paroxetine, fluoxetine, and sertraline, respectively. The norepinephrine-dopamine-reuptake inhibitor bupropion also produced a significant odds ratio of 1.23 (95% CI 1.01-1.49). The selective serotonin reuptake inhibitor and serotonin norepinephrine reuptake inhibitor classes of antidepressants pose a greater risk for causing congenital heart defects than the tricyclic antidepressants. However, this risk for in idual antidepressants within each class varies, and information regarding some antidepressants is still lacking.
No related grants have been discovered for Courtney De Vries.