A pregnant woman who takes an antidepressant for any length of time during her first trimester does not increase her chance of delivering a baby with a birth defect, a new Canadian study shows.
The study, conducted by researchers from the Universite de Montreal and the Centre Hospitalier Universitaire Saint-Justine, was published Thursday in The British Journal of Psychiatry.
The researchers analyzed data from more than 2,300 pregnant women in Quebec. The women had been diagnosed with at least one psychiatric disorder before pregnancy and had taken antidepressants for at least 30 days in the year leading up to pregnancy.
The research team found no increased risk of delivering a baby with birth defects if a mother took antidepressants during the first 30, 60 or 90 days of her pregnancy.
"No statistically significant association was found between antidepressant duration during the first trimester of pregnancy and the risk of major congenital malformations in infants," the study's authors wrote.
"In addition, the class of antidepressant used was not significantly associated with the occurrence of major birth defects."
The authors also found no difference in birth defect rates between women who used antidepressants during the first trimester and women who had not taken antidepressants at all during pregnancy.
The safety of antidepressant use during pregnancy has been a hotly debated topic in the medical community. However, the authors say that their findings support other research on the topic.
The researchers also point out that studies show women with psychiatric disorders who go untreated while pregnant are at a higher risk of developing other health behaviours, such as smoking and alcohol abuse, which could negatively impact the baby.
As well, a pregnant woman who abandons treatment has a higher risk of her symptoms returning, the authors say.
The researchers say their study should help doctors decide if their patients should continue to take antidepressants while pregnant.
They also suggest that scientists could next study if specific antidepressants have an effect on particular birth defects.
Abstract:
Duration of antidepressant use during pregnancy and risk of major congenital malformations
�lodie Ramos, MSc, Martin St-Andr�, MD, �velyne Rey, MD, Driss Oraichi, PhD, Anick B�rard, PhD
Background: Antidepressant use during the gestational period is a controversial topic.
Aims: To determine whether duration of antidepressant use during the first trimester increases the risk of major congenital malformations in offspring of women diagnosed with psychiatric disorders.
Method: A case-control study was performed among women who had been pregnant between January 1998 and December 2002. Data were obtained from a Medication and Pregnancy registry, built by linking three databases from the province of Quebec, and a self-administered questionnaire. Women eligible for this study had to be 15-45 years old at the beginning of pregnancy, have at least one diagnosis of psychiatric disorder before pregnancy, have used antidepressants for 30 days in the year prior to pregnancy and have a pregnancy ending with a delivery. Cases were defined as any major congenital malformation diagnosed in the offspring's first year of life. Odds ratios, adjusted for relevant confounders, were estimated using logistic regression.
Results: Among the 2329 women meeting the inclusion criteria, 189 (8.1%) infants were born with a major congenital malformation. Duration of antidepressant use during the first trimester of pregnancy was not associated with an increased risk of major congenital malformations: 1-30 days v. 0 day, adjusted OR=1.23 (95% CI 0.77-1.98); 31-60 days v. 0 day, adjusted OR=1.03 (95% CI 0.63-1.69); 61 days v. 0 day, adjusted OR=0.92 (95% CI 0.50-1.69).
Conclusions: These data do not support an association between duration of antidepressant use during the first trimester of pregnancy and major congenital malformations in the offspring of women with psychiatric disorders. These findings should help clinicians decide whether to continue antidepressant therapy during pregnancy.
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