Anti-depressants during pregnancy can increase birth defects risk

Using a medication prescribed to treat conditions including depression, obsessive-compulsive disorder, anxiety and post-traumatic stress disorder during the first trimester of pregnancy may increase newborns' risk of heart defects, says a study.

Up to one-fifth of women of childbearing age experience depressive symptoms that often lead to mild to moderate depression, and prescriptions for anti-depressants during pregnancy have increased in recent years.

The most common drugs for treating depression in pregnant women are selective serotonin reuptake inhibitors, and up until 2005, one drug in that class - paroxetine - was considered to be safe for use during pregnancy.

To provide a comprehensive assessment of the effects of paroxetine on newborns, the researchers conducted a literature review and analysis of all relevant studies published from 1966 to 2015. The investigators uncovered 23 eligible studies.

Compared with no use of paroxetine, first trimester use of paroxetine was associated with a 23 percent increased risk of any major congenital malformations and a 28 percent increased risk of major cardiac malformations in newborns, the study said.

"Indeed, the risk/benefit ratio suggests non-use in women with mild to moderately depressive symptoms, which is 85 percent of pregnant women with depressive symptoms," said lead researcher Anick Berard from University of Montreal in Canada.

"Therefore, planning of pregnancy is essential, and valid treatment options such as psychotherapy or exercise regimens are warranted in this special population," Berard said.

The study was published in the British Journal of Clinical Pharmacology.