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Maternal Use of Sertaline, Citalopram Linked to Septal Heart Defects in Offspring

Women who use the antidepressants sertraline (Zoloft) or citalopram (Celexa) early in pregnancy face increased risk for septal heart defects in their offspring, BMJ reports online.

Researchers examined data on more than 490,000 infants born in Denmark between 1996 and 2003. They found that women who filled prescriptions for sertraline and citalopram (but not other SSRIs) during their first trimester were significantly more likely to have children with septal heart defects (but not other malformations) than those who didn't use SSRIs (odds ratios: 3.2 and 2.5, respectively).

The authors and an editorialist (both with ties to SSRI manufacturers) note that the absolute risks for septal heart defects were low: 0.9% in children exposed to at least one SSRI and 2.1% in those exposed to more than one. The editorialist concludes: "Clinicians and patients need to balance the small risks associated with SSRIs against those associated with undertreatment or no treatment."

LINK(S):

BMJ article (Free)

BMJ editorial (Subscription required)

Recent American Psychiatic Association and American College of Obstetricians and Gynecologists report on management of maternal depression (Free abstract; full text requires subscription)

Previous Physicians First Watch coverage of SSRIs and congenital defects (Free)

Published in Physician's First Watch September 25, 2009