Study finds no link between antidepressants and heart defects in newborns

Concerns over whether the use of certain antidepressant medications during pregnancy led to cardiac defects in the infants are allayed somewhat by a new study of nearly one million pregnant women that found no connection.

by John Tyburski

Copyright © Daily Digest News, KPR Media, LLC. All rights reserved.

First published at Daily Digest News on June 18, 2014

A new cohort study that followed just under 950,000 pregnant women enrolled in Medicaid examined whether there is a connection between the use of selective serotonin-reuptake inhibitors (SSRIs), drugs that are commonly prescribed to treat depression, and cardiac defects in liveborn infants. The results of the study, which found no connection between SSRIs and infant heart problems, were published this week in the New England Journal of Medicine.

Past findings and an alert issued in 2005 by the U.S. Food and Drug Administration had created concern about using SSRIs like paroxetine (Paxil) and sertraline (Zoloft) during the first trimester of pregnancy. Experts suspected a link between right ventricular outflow tract obstruction and ventricular septal defects and Paxil and Zoloft, respectively.

“I don’t know if it will completely settle the debate over antidepressants during pregnancy, but I’m pleased to hear more support for the safety of these medicines in pregnancy,” Dr. Rebecca Starck, Director of Regional Obstetrics and Gynecology at the Cleveland Clinic, Ohio, told Reuters Health. “I think many practitioners and obstetricians will be happy to see this study come out.” Starck was not involved with the study.

The study was conducted with Medicaid records on subjects of the Medicaid Analytic eXtract, a larger, nationwide effort, from 2000 through 2007. During these years, women in the Medicaid program from three months before their last menstruation through one month after giving birth to a live infant were followed. Among these women, more than 64,000, or 6.8 percent, used antidepressants during the first trimester of their pregnancies. In comparison, approximately 10 to 15 percent of pregnant women in the U.S. are diagnosed with depression.

“We did not find any association for any of the antidepressant categories or the individual drugs we studied,” lead author Dr. Krista Huybrechts of Brigham and Women’s Hospital in Boston said. “It will be up to individual physicians and women to determine how much it will sway their opinion one way or the other.”

Looking only at antidepressant use and cardiac defects in the infants born to the depressed mothers suggested an almost 25 percent increase of risk associated with SSRI use. However, once the researchers adjusted their risk model for activities that depressed women engage in, the association disappeared.

“Women with depression often have behaviors that tend to increase their risk,” said Huybrechts. “They tend to have a high use of alcohol, they tend to be smokers and they use other psychotropic medications that might have some association.”

The authors of the report did not disclose any potential conflicts of interest or funding from drug makers.