Using an antidepressant medication during pregnancy has been associated with an increased risk of birth defects in more than a dozen studies. Even so, many women were completely unaware of this risk.
Depression is a serious illness that primarily affects women of childbearing age. Thousands of women have used an antidepressant medication during pregnancy to control symptoms of depression, panic disorders, anxiety, obsessive-compulsive disorder, and more.
The three classes of antidepressants are:
- Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs), including Effexor (venlafaxine), Pristiq (desvenlafaxine), and Cymbalta (duloxetine)
- Selective Serotonin Reuptake Inhibitors (SSRIs), including Prozac (fluoxetine), Zoloft (sertraline), Celexa (citalopram), Lexapro (escitalopram), and more
- Monoamine Oxidate Inhibitors (MAOIs), including Nardil (phenelzine), Marplan (isocarboxazid), and Parnate (tranylcypromine)
Studies of Antidepressants and Birth Defects
More than a dozen studies have linked antidepressants to birth defects. Most of these studies focus on the SSRI class of antidepressants, because these are the oldest and most widely-used antidepressants.
It is important to note that no adequate or well-controlled studies have been conducted of antidepressants during pregnancy. It would be unethical to randomly select pregnant women, give them an antidepressant or a placebo, and monitor for birth defects. Therefore, most experts agree that antidepressants should only be used during pregnancy if the possible benefits outweigh any potential risks.
This study from 2006 reviewed existing studies of antidepressants and birth defects, and found the following associations:
- Fetal withdrawal occurred in 20-30% of infants exposed to an SSRI during the third trimester. Symptoms included vomiting, irritability, respiratory distress, seizures, and more.
- A study from Denmark that involved 1,054 pregnant women found that SSRIs were associated with a 40% increased risk of birth defects and a 60% increased risk of heart defects.
- Paxil (paroxetine) is an SSRI that was associated with a 4% risk of birth defects and a 2% risk of heart defects.
- Research based on a registry of birth defects in America found a 1.8-fold increased risk of craniosynostosis (a type of skull defect) and a 3-fold increased risk of omphalocele (an abdominal defect)
Antidepressant Birth Defects
When a pregnant woman uses an antidepressant, the medication can pass through the placenta and affect fetal development. Although no one knows exactly how antidepressants influence a fetus, studies have linked the medications to the following types of birth defects:
- Heart defects (especially “hole-in-the-heart” or septal defects)
- Persistent Pulmonary Hypertension of the Newborn (PPHN)
- Abdominal defects (omphalocele, gastroschisis)
- Neural tube defects (spina bifida, anencephaly, etc.)
- Limb defects (clubfoot)
- Cranial defects (craniosynostosis)
- Premature birth, miscarriage, low birth weight
- Fetal withdrawal symptoms
- And more