Original Article
First-Trimester Use of Selective Serotonin-Reuptake Inhibitors and the Risk of Birth Defects
N Engl J Med 2007; 356:2675-2683June 28, 2007
- Abstract
Background
The risk of birth defects after antenatal exposure to selective serotonin-reuptake inhibitors (SSRIs) remains controversial.
Methods
We assessed associations between first-trimester maternal use of SSRIs and the risk of birth defects among 9849 infants with and 5860 infants without birth defects participating in the Slone Epidemiology Center Birth Defects Study.
Results
In analyses of defects previously associated with SSRI use (involving 42 comparisons), overall use of SSRIs was not associated with significantly increased risks of craniosynostosis (115 subjects, 2 exposed to SSRIs; odds ratio, 0.8; 95% confidence interval [CI], 0.2 to 3.5), omphalocele (127 subjects, 3 exposed; odds ratio, 1.4; 95% CI, 0.4 to 4.5), or heart defects overall (3724 subjects, 100 exposed; odds ratio, 1.2; 95% CI, 0.9 to 1.6). Analyses of the associations between individual SSRIs and specific defects showed significant associations between the use of sertraline and omphalocele (odds ratio, 5.7; 95% CI, 1.6 to 20.7; 3 exposed subjects) and septal defects (odds ratio, 2.0; 95% CI, 1.2 to 4.0; 13 exposed subjects) and between the use of paroxetine and right ventricular outflow tract obstruction defects (odds ratio, 3.3; 95% CI, 1.3 to 8.8; 6 exposed subjects). The risks were not appreciably or significantly increased for other defects or other SSRIs or non-SSRI antidepressants. Exploratory analyses involving 66 comparisons showed possible associations of paroxetine and sertraline with other specific defects.
Conclusions
Our findings do not show that there are significantly increased risks of craniosynostosis, omphalocele, or heart defects associated with SSRI use overall. They suggest that individual SSRIs may confer increased risks for some specific defects, but it should be recognized that the specific defects implicated are rare and the absolute risks are small.
Media in This Article
Table 1
Rates of Exposure to Antidepressants within Outcome Groups.Table 2
Adjusted Odds Ratios and 95% Confidence Intervals for Specific SSRIs in Relation to Outcomes Previously Reported to Be Associated with SSRI Use.Article Activity
- Article
Symptoms of clinical depression affect 8 to 20% of women1,2; during pregnancy, about 10% of women are affected,3 and many of these women are treated with antidepressants. In the late 1980s, a new class of antidepressants, selective serotonin-reuptake inhibitors (SSRIs), appeared and rapidly gained widespread acceptance because they have fewer side effects than the older tricyclic antidepressants and pose less risk when taken in overdose.4 However, concern has been raised about their potential effects on the fetus. Neonatal effects, known as “SSRI neonatal withdrawal syndrome” or “SSRI abstinence syndrome,”5-9 are now well established, but the relation of antenatal SSRI exposure to birth defects remains controversial.
Early studies9-15 demonstrated that SSRIs were not “major teratogens” similar to thalidomide or isotretinoin.16 More recently, however, elevated risks of birth defects overall,17,18 as well as elevated risks of omphalocele,19 craniosynostosis,19 and congenital heart defects,18,20-22 have been reported in association with the use of SSRIs. One study specifically identified paroxetine as increasing the risk of omphalocele,19 and three have associated this SSRI with congenital heart defects.20-22 However, none of these studies considered risks of cardiac defects in relation to other specific SSRIs. Using data from the Slone Epidemiology Center Birth Defects Study, an ongoing program of case–control surveillance of medications in relation to birth defects, we evaluated these hypotheses and also considered other specific birth defects in relation to first-trimester use of specific SSRIs.
Methods
Study Design
The Birth Defects Study began in 1976, focusing both on testing existing hypotheses and on identifying previously unsuspected associations; the methods have been described.23,24 Infants with any of a wide range of malformations are identified in five study centers that include the areas surrounding Boston, Philadelphia, Toronto, and San Diego, as well as a portion of New York State. Research staff identify subjects by reviewing clinical and surgical logs, reviewing admission and discharge lists, and contacting newborn nurseries and labor and delivery rooms. Subjects in New York State and, since 1998, in Massachusetts are identified from statewide birth-defect registries. Infants with isolated minor defects (e.g., accessory nipples, dislocatable hips, and low-set ears) are excluded. Nonmalformed infants were identified at study hospitals until 1998; subsequently, enrollment was expanded to include a population-based random sample of newborns in Massachusetts. This study has been approved by the institutional review boards at Boston University and other participating institutions.
Mothers of identified infants are invited to participate by completing a 45-to-60-minute interview (in person until 1998 and by telephone thereafter) within 6 months after delivery, conducted by trained study nurses who are unaware of the study hypotheses. Oral informed consent is obtained from the mothers. The interview elicits information on demographic, reproductive, and medical factors, cigarette smoking, and the consumption of alcohol and caffeine. Detailed data are collected on all medications (prescription, over-the-counter, vitamins and minerals, and herbal products) used at any time from 2 months before conception through the end of the pregnancy.
Using a multilevel approach,25 we first ask women whether they had any of a list of specific illnesses during pregnancy and what drugs they used to treat those conditions. We then ask about use of medications for specific indications, including “anxiety,” “depression,” and “other psychological conditions.” Finally, independent of their responses to the previous questions, each woman is asked about her use of named medications, identified by brand name, including Prozac (fluoxetine), Zoloft (sertraline), Paxil (paroxetine), Effexor (venlafaxine), Elavil (amitriptyline), Celexa (citalopram), Luvox (fluvoxamine), Lexapro (escitalopram), and Wellbutrin (bupropion).
The current analysis was restricted to women whose last menstrual period occurred between January 1, 1993, and December 31, 2004. We excluded subjects whose infants had chromosomal defects, known mendelian inherited disorders, syndromes, defects with a known cause (e.g., fetal alcohol syndrome), and metabolic disorders (e.g., phenylketonuria and glucose-6-phosphate dehydrogenase deficiency). Among subjects, 22.7% of mothers and 25.4% of controls declined to participate. Another 15.6% of mothers and 14.7% of controls either did not respond to repeated contacts or were unavailable for interview.
Assessment of Previously Reported Associations
Previous reports have associated craniosynostosis, omphalocele, and congenital heart defects with the use of SSRIs. Because heart defects represent developmentally diverse outcomes, we created seven developmentally based subgroups.26 In order of embryologic development, these are looping, laterality, and single-ventricle defects (e.g., situs inversus totalis and double-inlet left ventricle); conotruncal defects (e.g., tetralogy of Fallot and double-outlet right ventricle); atrioventricular canal defects (e.g., endocardial cushion defect and common atrioventricular canal defect); right ventricular outflow tract obstruction (e.g., pulmonary valve atresia or stenosis and Ebstein's anomaly); left ventricular outflow tract obstruction (e.g., aortic valve atresia or stenosis and hypoplastic left heart); septal defects (e.g., ventricular septal defect and atrial septal defect); and total or partial anomalous pulmonary venous return. A complete list is provided in the Supplementary Appendix, available with the full text of this article at www.nejm.org.
A clinical geneticist trained in pediatric cardiology reviewed the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM), codes of each case and, where possible, assigned the case to one or more of the seven groups. Cases were assigned to as many of these categories as their ICD codes would indicate, but in some situations, considerations of developmental processes took precedence. For example, a case with anomalous pulmonary venous return and a septal defect, along with the additional diagnosis of asplenia, was assigned to the developmentally appropriate category of “laterality defect.”
Exploratory Analyses
In addition to the defects previously associated with SSRIs, we examined other specific defects that were present in at least 100 subjects overall and at least 5 exposed subjects.
Exposure
We considered first-trimester exposure to include use of any SSRI from 28 days before the last menstrual period through the fourth lunar month (112 days after the last menstrual period). The analysis of specific SSRIs excluded 79 women who took more than one SSRI during this period. To consider possible “confounding by indication,” in which an apparent association between an outcome and medication is actually due to the condition for which the medication is used, we also investigated exposure to non-SSRI antidepressants (e.g., tricyclic antidepressants, bupropion, and venlafaxine; the latter has both serotonin and norepinephrine activity and represented 20% of this group). The reference group for all analyses was women not exposed to any antidepressant at any time from 56 days before the last menstrual period through the end of pregnancy. To avoid misclassification, we excluded women whose only exposure to antidepressants was between 28 and 56 days before the last menstrual period or after lunar month 4.
Statistical Analysis
Odds ratios and 95% confidence intervals were calculated separately for each exposure and outcome by multiple logistic regression. To assess confounding, we explored factors that were associated with exposure to any SSRI and to the risk of birth defects overall, including maternal age, maternal race or ethnic group (self-reported), maternal education, year of last menstrual period, parity, study center, first-trimester smoking, first-trimester alcohol consumption, history of a birth defect in a first-degree relative, prepregnant body-mass index, seizures, diabetes mellitus, hypertension, infertility, and first-trimester use of folic acid. Because some birth defects have been associated with obesity,27-30 we also explored effect modification by body-mass index for each outcome with an increased risk. No statistical adjustment was made for multiple testing.
Results
A total of 9849 infants with malformations and 5860 control infants were included in the analysis. Among outcomes previously reported to be associated with SSRI use, there were 127 cases of omphalocele, 115 cases of craniosynostosis, and 3724 cases of congenital heart defects; the latter included 186 looping or laterality defects, 620 conotruncal defects, 164 atrioventricular defects, 363 right ventricular outflow tract obstruction defects, 482 left ventricular outflow tract obstruction defects, 1161 septal defects, and 17 cases of anomalous pulmonary venous return.
For exploratory analyses, we identified 17 diagnosis groups that had 100 or more subjects. Six groups were excluded from further analysis because they had fewer than 5 subjects who had been exposed to an SSRI: esophageal atresia (189 subjects, 4 exposed), absent kidney (178 subjects, 4 exposed), horseshoe or accessory kidney (127 subjects, 4 exposed), abnormal intestinal rotation (149 subjects, 3 exposed), cystic kidney (179 subjects, 2 exposed), and small intestinal atresia (129 subjects, 2 exposed).
Table 1Table 1
Rates of Exposure to Antidepressants within Outcome Groups. shows the rates of exposure to any SSRI, specific SSRIs, and non-SSRI antidepressants for each outcome and for the control subjects, who had no malformations. Because few subjects had been exposed to fluvoxamine (five subjects) and escitalopram (eight subjects), these medications were not considered further. Similarly, we did not analyze looping and laterality defects (two SSRI-exposed subjects), atrioventricular canal defects (no SSRI-exposed subjects), and anomalous pulmonary venous return (no SSRI-exposed subjects).Assessment of Previous Hypotheses
Table 2Table 2
Adjusted Odds Ratios and 95% Confidence Intervals for Specific SSRIs in Relation to Outcomes Previously Reported to Be Associated with SSRI Use. shows the results for the 42 comparisons related to craniosynostosis, omphalocele, congenital heart defects, and the four specific cardiac-defect groups, adjusted for potential confounders.There was no significant increase in the risk of craniosynostosis associated with the use of SSRIs overall or with individual SSRIs; only 2 of 115 subjects with craniosynostosis had been exposed to an SSRI (1 to sertraline and 1 to paroxetine). For omphalocele, 3 of 127 subjects had been exposed to an SSRI, all to sertraline (odds ratio, 5.7; 95% confidence interval [CI], 1.6 to 20.7).
We found no appreciable or significantly increased risk of congenital heart defects overall in relation to the use of SSRIs overall (odds ratio, 1.2; 95% CI, 0.9 to 1.6). However, when we assessed associations between specific heart-defect subgroups and individual SSRIs, the odds ratios ranged from 0.5 to 3.3, and two risk estimates had lower bounds that exceeded 1.0: sertraline in relation to septal defects (odds ratio, 2.0; 95% CI, 1.2 to 4.0, based on 13 exposed subjects) and paroxetine in relation to right ventricular outflow tract obstruction defects (odds ratio, 3.3; 95% CI, 1.3 to 8.8, based on 6 exposed subjects). No appreciable or significantly increased risks were associated with fluoxetine (range of odds ratios, 1.0 to 1.6), nor were there appreciable or significant associations between non-SSRI antidepressants and any of the specific birth defects examined.
Exploratory Analyses
Table 3Table 3
Adjusted Odds Ratios and 95% Confidence Intervals for Specific SSRIs in Relation to Outcomes Not Previously Reported to Be Associated wtih SSRI Use. presents risk estimates for other birth defects, adjusted for potential confounders. Among 66 comparisons, 4 had lower confidence bounds that exceeded 1.0: sertraline in relation to anal atresia and limb-reduction defects (3 exposed subjects for each defect) and paroxetine in relation to neural-tube defects and clubfoot (4 and 10 exposed subjects, respectively). One association, that between paroxetine use and undescended testis, had a lower confidence bound of 1.0. For non-SSRI antidepressants, risk estimates ranged from 0.6 to 1.2, with one exception: an odds ratio of 2.2 for anal atresia, based on three exposed subjects (lower 95% confidence bound, 0.6). For positive associations, no mothers of exposed subjects reported exposure to any suspected teratogenic drugs.17 We also investigated effect modification by body-mass index for associations with elevated risks. Although there was a tendency for risks to be higher in overweight and obese women than in women of normal weight, there were too few exposed women in each category to generate stable results (data not shown).
Discussion
Our analysis did not confirm previously reported associations between overall use of SSRIs and craniosynostosis, omphalocele, or heart defects as a group. Alwan et al.19 previously reported increased risks of craniosynostosis and omphalocele associated with maternal SSRI use and found paroxetine to be most strongly associated with omphalocele. We did not replicate these findings: no infant with omphalocele and only one with craniosynostosis was exposed to paroxetine among our study population. The only significant association we found between either of these two defects and the use of SSRIs was an association between sertraline use and omphalocele (odds ratio, 5.7; 95% CI, 1.6 to 20.7), which was based on only three exposed subjects.
We did not find significantly increased risks of congenital heart defects overall associated with overall use of SSRIs or of non-SSRI antidepressants. However, using an embryologically based classification of heart defects, we found a doubling of the risk of septal defects associated with sertraline use (odds ratio, 2.0), based on 13 exposed subjects, and a tripling of the risk of right ventricular outflow tract obstruction defects associated with paroxetine use (odds ratio, 3.3), based on 6 exposed subjects. The latter finding is supported by an odds ratio of 2.5, based on seven exposed subjects (95% CI, 1.0 to 9.6), identified by Alwan et al. in an article in this issue of the Journal.31 These more detailed findings were derived from two case–control surveillance studies with data sets large enough to consider both specific malformations and specific SSRIs.
Our observations of significant increases in the risk of selected cardiac defects with the use of certain SSRIs may reflect different teratologic effects among specific drugs within a given pharmacologic class.32 For SSRIs, this possibility is supported by the fact that various class members have parent compounds and metabolites with different pharmacologic characteristics.33-35 However, we cannot rule out the possibility of chance associations, given the multiple comparisons performed.
The previously unreported associations we identified warrant particularly cautious interpretation. In the absence of preexisting hypotheses and the presence of multiple comparisons, distinguishing random variation from true elevations in risk is difficult. Despite the large size of our study overall, we had limited numbers to evaluate associations between rare outcomes and rare exposures. We included results based on small numbers of exposed subjects in order to allow other researchers to compare their observations with ours, but we caution that these estimates should not be interpreted as strong evidence of increased risks. On the basis of the magnitude of the risk estimate and the number of exposed subjects, certain associations warrant further exploration: sertraline in relation to anal atresia and limb-reduction defects, and paroxetine in relation to neural-tube defects and clubfoot.
Among all defects evaluated, we found that, for fluoxetine, no risk estimate exceeded 2.0 and none had a lower confidence bound exceeding 1.0. For non-SSRI antidepressants, no risk estimate exceeded 1.2, except for anal atresia, and the confidence interval for that estimate, based on three exposed subjects, did not exclude 1.0. On the other hand, sertraline and paroxetine were associated with significant increases in specific birth defects, none of which were common to both drugs.
Recall bias may be a concern, since mothers of infants with malformations may recall and report exposures more completely than mothers of the control subjects who had no malformations. However, we consider this unlikely, since antidepressants are typically used on a regular basis for nontrivial indications, and recall of their use may be less subject to such bias than medications used infrequently and more casually. Further, the use of a multilevel structured questionnaire to identify medication use should minimize recall bias25 and has been shown to elicit rates of use similar to estimates from marketing data.36 Moreover, the null effects we observed among the non-SSRI antidepressants argue against recall bias, and recall bias would not explain risks associated with some individual SSRIs but not with others. Selection bias is unlikely, since mothers are invited to participate without knowledge of exposure. Detection bias is also unlikely, given the differential effects of non-SSRIs as compared with specific SSRIs and variability in the effects among specific SSRIs.
Confounding by uncontrolled factors is always possible in observational studies. We considered a large number of relevant demographic, medical, and reproductive factors. A major potential confounder is the effect of depression itself, unrelated to drug treatment. However, the absence of significantly increased risks of various birth defects associated with the use of non-SSRI antidepressants suggests that depression itself is unlikely to be the cause of the defects studied. The possibility that chance accounts for some or all of these results cannot be ruled out, especially in view of the many comparisons that were made in these analyses (42 in assessing previously reported associations and 66 in exploratory analyses). For that reason, we place greater reliance on findings that are consistent with previous studies, and we await further research on newly reported associations.
Our understanding of the risks to the fetus of SSRI use has evolved from initial small cohort studies that ruled out major teratogenic risks to more recent efforts that have raised questions about moderate overall increases in risk as well as increases in broad categories of defects, such as cardiac anomalies. The current study suggests that specific SSRIs may increase the risk of specific birth defects, and further studies will need sufficient power to pursue these important clinical questions. In the meantime, it is important to keep in perspective that the absolute risks of these rare defects are small. For example, the baseline prevalences of anal atresia37 and right ventricular outflow tract obstruction defects26 are each estimated to be about 5.5 cases per 10,000 live births; thus, even if a specific SSRI increased rates by a factor of four, the risk of having an affected child would still be only 0.2%.
The Slone Epidemiology Center Birth Defects Study was supported in part by grants from the National Institute of Child Health and Human Development (HD27697) and the National Heart, Lung, and Blood Institute (HL50763). Additional support was provided by Aventis and Sanofi Pasteur. This data analysis was supported in part by a contract from GlaxoSmithKline, the manufacturer of Paxil (paroxetine). Responsibility for this analysis and the manuscript rests solely with the authors.
Drs. Louik, Mitchell, and Werler report receiving support from Sanofi Pasteur to identify rates of use of various vaccines in pregnancy. Dr. Mitchell reports participating (unpaid) in an advisory committee for GlaxoSmithKline's Lamotrigine Pregnancy Registry and serving as principal investigator of the Isotretinoin Survey (2002–2006), sponsored by Barr Pharmaceuticals, Ranbaxy Laboratories, and Genpharm; all these companies manufacture generic forms of antidepressants included in this study. Dr. Werler reports participating in scientific advisory boards for pregnancy registries of rheumatoid arthritis medications marketed by Sanofi-Aventis, Abbott Laboratories, and Amgen. No other potential conflict of interest relevant to this article was reported.
We thank Dawn Jacobs, Fiona Rice, Rita Krolak, Kathleen Sheehan, Karen Bennett Mark, Clare Coughlin, Nastia Dynkin, Nancy Rodriquez-Sheridan, and Meghan Malone-Moses for their assistance in data collection and computer programming; the staff of the Massachusetts Department of Public Health Center for Birth Defects Research and Prevention, Charlotte Druschel and the New York State Health Department, and Christina Chambers and Kenneth Jones of the University of California, San Diego (UCSD), as well as the medical and nursing staff at the following participating hospitals for assistance with case ascertainment: Baystate Medical Center, Beth Israel Deaconess Medical Center, Boston Medical Center, Brigham and Women's Hospital, Brockton Hospital, Cambridge Hospital, Caritas Good Samaritan Medical Center, Charlton Memorial Hospital, Boston Children's Hospital, Emerson Hospital, Falmouth Hospital, Haverhill–Hale Hospital, Jordan Hospital, Kent Hospital, Lawrence General Hospital, Lowell General Hospital, Melrose–Wakefield Hospital, Metro West Medical Center–Framingham, Mt. Auburn Hospital, New England Medical Center, Newton–Wellesley Hospital, North Shore Medical Center, Rhode Island Hospital, Saints Memorial Medical Center, South Shore Hospital, Southern New Hampshire Medical Center, St. Elizabeth's Medical Center, St. Luke's Hospital, St. Vincent Hospital, University of Massachusetts Memorial Health Care, Women & Infants' Hospital, Abington Memorial Hospital, Albert Einstein Medical Center, Alfred I. duPont Hospital for Children, Bryn Mawr Hospital, Chester County Hospital, Children's Hospital of Philadelphia, Christiana Care Health Services, Community Hospital, Crozer–Chester Medical Center, Doylestown Hospital, Frankford Hospital, Hahnemann University Hospital, the Hospital of the University of Pennsylvania, Lankenau Hospital, Lancaster General Hospital, Lehigh Valley Hospital, Nanticoke Memorial Hospital, Pennsylvania Hospital, Sacred Heart Hospital, St. Christopher's Hospital for Children, St. Mary Medical Center, Temple University Health Sciences Center, Reading Hospital & Medical Center, Thomas Jefferson University Hospital, Grand River Hospital, Guelph General Hospital, Hamilton Health Sciences Corporation, the Hospital for Sick Children, Humber River Regional Hospital–Church Site, Humber River Regional Hospital–Finch Site, Joseph Brant Memorial Hospital, Lakeridge Health Corporation, London Health Sciences Center, Mt. Sinai Hospital, North York General Hospital, Oakville Trafalgar Memorial Hospital, Scarborough Hospital–General Division, Scarborough Hospital–Grace Division, St. Joseph's Health Centre–London, St. Joseph's Health Centre–Toronto, St. Joseph's Healthcare–Hamilton, St. Michael's Hospital, Sunnybrook & Women's College Health Sciences Center, Toronto East General Hospital, Toronto General Hospital, Trillium Health Center, William Osler Heath Centre, York Central Hospital, York County Hospital, Alvarado Hospital, Balboa Naval Medical Center, Camp Pendleton Naval Hospital, Children's Hospital and Health Center, Kaiser Zion Medical Center, Palomar Medical Center, Pomerado Hospital, Scripps Mercy Hospital, Scripps Memorial Hospital–Chula Vista, Scripps Memorial Hospital–Encinitas, Scripps Memorial Hospital–La Jolla, Sharp Chula Vista Hospital, Sharp Coronado Hospital, Sharp Grossmont Hospital, Sharp Mary Birch Hospital, Tri-City Medical Center, and UCSD Medical Center. We also thank all the mothers who participated in the study.
Source Information
From the Slone Epidemiology Center at Boston University (C.L., M.M.W., S.H.-D., A.A.M.), the Genetics Unit, Massachusetts General Hospital for Children (A.E.L.), and the Department of Epidemiology, Harvard School of Public Health (S.H.-D.) — all in Boston.
Address reprint requests to Dr. Louik at the Slone Epidemiology Center, 1010 Commonwealth Ave., Boston, MA 02215, or at clouik@slone.bu.edu.
- References
References
1
Kessler RC ,McGonagle KA ,Swartz M ,Blazer DG ,Nelson CB . Sex and depression in the National Comorbidity Survey. I. Lifetime prevalence, chronicity and recurrence. J Affect Disord 1993;29:85-96
CrossRef | Web of Science | Medline2
Llewellyn AM ,Stowe ZN ,Nemeroff CB . Depression during pregnancy and the puerperium. J Clin Psychiatry 1997;58:Suppl 15:26-32
CrossRef | Web of Science | Medline3
Bennett HA ,Einarson A ,Taddio A ,Koren G ,Einarson TR . Prevalence of depression during pregnancy: systematic review. Obstet Gynecol 2004;103:698-709[Erratum, Obstet Gynecol 2004;103:1344.]
CrossRef | Web of Science | Medline4
Committee on Drugs, American Academy of Pediatrics
CrossRef | Web of Science | Medline5
Cohen LS ,Heller VL ,Bailey JW ,Grush L ,Ablon JS ,Bouffard SM . Birth outcomes following prenatal exposure to fluoxetine. Biol Psychiatry 2000;48:996-1000
CrossRef | Web of Science | Medline6
Levinson-Castiel R ,Merlob P ,Linder N ,Sirota L ,Klinger G . Neonatal abstinence syndrome after in utero exposure to selective serotonin reuptake inhibitors in term infants. Arch Pediatr Adolesc Med 2006;160:173-176
CrossRef | Web of Science | Medline7
Malm H ,Klaukka T ,Neuvonen PJ . Risks associated with selective serotonin reuptake inhibitors in pregnancy. Obstet Gynecol 2005;106:1289-1296
CrossRef | Web of Science | Medline8
Sanz EJ ,De-las-Cuevas C ,Kiuru A ,Bate A ,Edwards R . Selective serotonin reuptake inhibitors in pregnant women and neonatal withdrawal syndrome: a database analysis. Lancet 2005;365:482-487
Web of Science | Medline9
Simon GE ,Cunningham ML ,Davis RL . Outcomes of prenatal antidepressant exposure. Am J Psychiatry 2002;159:2055-2061
CrossRef | Web of Science | Medline10
Pastuszak A ,Schick-Boschetto B ,Zuber C , et al. Pregnancy outcome following first-trimester exposure to fluoxetine (Prozac). JAMA 1993;269:2246-2248
CrossRef | Web of Science | Medline11
Kulin NA ,Pastuszak A ,Sage SR , et al. Pregnancy outcome following maternal use of the new selective serotonin reuptake inhibitors: a prospective controlled multicenter study. JAMA 1998;279:609-610
CrossRef | Web of Science | Medline12
Chambers CD ,Johnson KA ,Dick LM ,Felix RJ ,Jones KL . Birth outcomes in pregnant women taking fluoxetine. N Engl J Med 1996;335:1010-1015
Full Text | Web of Science | Medline13
Ericson A ,Kallen B ,Wiholm B . Delivery outcome after the use of antidepressants in early pregnancy. Eur J Clin Pharmacol 1999;55:503-508
CrossRef | Web of Science | Medline14
Nulman I ,Rovet J ,Stewart DE , et al. Neurodevelopment of children exposed in utero to antidepressant drugs. N Engl J Med 1997;336:258-262
Full Text | Web of Science | Medline15
Sivojelezova A ,Shuhaiber S ,Sarkissian L ,Einarson A ,Koren G . Citalopram use in pregnancy: prospective comparative evaluation of pregnancy and fetal outcome. Am J Obstet Gynecol 2005;193:2004-2009
CrossRef | Web of Science | Medline16
Mitchell AA . Systematic identification of drugs that cause birth defects -- a new opportunity. N Engl J Med 2003;349:2556-2559
Full Text | Web of Science | Medline17
Epidemiology study: updated preliminary report on bupropion in pregnancy and the occurrence of cardiovascular and major congenital malformation. GlaxoSmithKline, 2005. (Accessed June 1, 2007, at http://www.gsk.com/media/paroxetine/ingenix_study.pdf.)
18
Wogelius P ,Norgaard M ,Gislum M , et al. Maternal use of selective serotonin reuptake inhibitors and risk of congenital malformations. Epidemiology 2006;17:701-704
CrossRef | Web of Science | Medline19
Alwan S ,Reefhuis J ,Rasmussen S ,Olney R ,Friedman JM . Maternal use of selective serotonin re-uptake inhibitors and risk for birth defects. Birth Defects Res A Clin Mol Teratol 2005;73:291-291
Web of Science20
Cole JA ,Ng EW ,Ephross SA ,Cosmatos IS ,Walker AM . Paroxetine in the first trimester of pregnancy and the prevalence of congenital malformations. Pharmacoepidemiol Drug Saf 2006;15:S6-S6
Web of Science21
Diav-Citrin O ,Shechtman S ,Weinbaum D , et al. Paroxetine and fluoxetine in pregnancy: a multicenter prospective, controlled study. Reprod Toxicol 2005;20:459-45922
Kallen BAJ ,Olausson PO . Antidepressant drugs during pregnancy and infant congenital heart defect. Reprod Toxicol 2006;21:221-222
CrossRef | Web of Science | Medline23
Mitchell AA ,Rosenberg L ,Shapiro S ,Slone D . Birth defects related to Bendectin use in pregnancy. I. Oral clefts and cardiac defects. JAMA 1981;245:2311-2314
CrossRef | Web of Science | Medline24
Werler MM ,Hayes C ,Louik C ,Shapiro S ,Mitchell AA . Multivitamin supplementation and risk of birth defects. Am J Epidemiol 1999;150:675-682
Web of Science | Medline25
Mitchell AA ,Cottler LB ,Shapiro S . Effect of questionnaire design on recall of drug exposure in pregnancy. Am J Epidemiol 1986;123:670-676
Web of Science | Medline26
Ferencz CL, Correa-Villasenor A, Loffredo CA, Wilson PD, eds. Perspectives in pediatric cardiology: genetic and environmental risk factors of major cardiovascular malformations. Armonk, NY: Futura Publishing, 1997.
27
Anderson JL ,Waller DK ,Canfield MA ,Shaw GM ,Watkins ML ,Werler MM . Maternal obesity, gestational diabetes, and central nervous system birth defects. Epidemiology 2005;16:87-92
CrossRef | Web of Science | Medline28
Mikhail LN ,Walker CK ,Mittendorf R . Association between maternal obesity and fetal cardiac malformations in African Americans. J Natl Med Assoc 2002;94:695-700
Web of Science | Medline29
Moore LL ,Singer MR ,Bradlee ML ,Rothman KJ ,Milunsky A . A prospective study of the risk of congenital defects associated with maternal obesity and diabetes mellitus. Epidemiology 2000;11:689-694
CrossRef | Web of Science | Medline30
Watkins ML ,Rasmussen SA ,Honein MA ,Botto LD ,Moore CA . Maternal obesity and risk for birth defects. Pediatrics 2003;111:1152-1158
Web of Science | Medline31
Alwan S ,Reefhuis J ,Rasmussen SA ,Olney RS ,Friedman JM . Use of selective serotonin-reuptake inhibitors in pregnancy and the risk of birth defects. N Engl J Med 2007;356:2684-2692
Full Text | Web of Science | Medline32
Mitchell AA. Studies of drug-induced birth defect. In: Strom BL, ed. Pharmacoepidemiology. 4th ed. New York: Wiley, 2005:501-14.
33
Hemeryck A ,Belpaire FM . Selective serotonin reuptake inhibitors and cytochrome P-450 mediated drug-drug interactions: an update. Curr Drug Metab 2002;3:13-37
CrossRef | Web of Science | Medline34
Nemeroff CB ,DeVane CL ,Pollock BG . Newer antidepressants and the cytochrome P450 system. Am J Psychiatry 1996;153:311-320
Web of Science | Medline35
Preskorn SH . Clinically relevant pharmacology of selective serotonin reuptake inhibitors: an overview with emphasis on pharmacokinetics and effects on oxidative drug metabolism. Clin Pharmacokinet 1997;32:Suppl 1:1-21
CrossRef | Web of Science | Medline36
Mitchell AA ,Schwingl PJ ,Rosenberg L ,Louik C ,Shapiro S . Birth defects in relation to Bendectin use in pregnancy. II. Pyloric stenosis. Am J Obstet Gynecol 1983;147:737-742
Web of Science | Medline37
Heinonen OP, Slone D, Shapiro S, et al. Birth defects and drugs in pregnancy. Littleton, MA: Publishing Sciences Group, 1977.
- Citing Articles (114)
Citing Articles
1
Katherine M. Knapp, Susan B. Brogly, Daniel G. Muenz, Hans M. L. Spiegel, Daniel H. Conway, Gwendolyn B. Scott, Jeffrey T. Talbot, David E. Shapiro, Jennifer S. Read. (2012) Prevalence of Congenital Anomalies in Infants With In Utero Exposure to Antiretrovirals. The Pediatric Infectious Disease Journal 31:2, 164-170
CrossRef2
Luke E. Grzeskowiak, Andrew L. Gilbert, Janna L. Morrison. (2012) Investigating Outcomes Associated with Medication Use During Pregnancy: A review of methodological challenges and observational study designs. Reproductive Toxicology
CrossRef3
René Ernst Nielsen, Per Damkier. (2012) Pharmacological treatment of unipolar depression during pregnancy and breast-feeding—A clinical overview. Nordic Journal of Psychiatry1-8
CrossRef4
Cynthia M. Nijenhuis, Peter G. J. ter Horst, Lolkje T. W. de Jong-van den Berg, Bob Wilffert. (2012) Disturbed development of the enteric nervous system after in utero exposure of selective serotonin re-uptake inhibitors and tricyclic antidepressants. Part 1: Literature review. British Journal of Clinical Pharmacology 73:1, 16-26
CrossRef5
Orna Diav-Citrin, Asher Ornoy. (2012) Selective Serotonin Reuptake Inhibitors in Human Pregnancy: To Treat or Not to Treat?. Obstetrics and Gynecology International 2012, 1-12
CrossRef6
Cynthia M. Nijenhuis, Peter G. J. ter Horst, Nienke van Rein, Bob Wilffert, Lolkje T. W. de Jong-van den Berg. (2012) Disturbed development of the enteric nervous system after in utero exposure of selective serotonin re-uptake inhibitors and tricyclic antidepressants. Part 2: Testing the hypotheses. British Journal of Clinical Pharmacology 73:1, 126-134
CrossRef7
Michael A. Thomas, Parag P. Joshi, Rebecca D. Klaper. (2012) Gene-class analysis of expression patterns induced by psychoactive pharmaceutical exposure in fathead minnow (Pimephales promelas) indicates induction of neuronal systems. Comparative Biochemistry and Physiology Part C: Toxicology & Pharmacology 155:1, 109-120
CrossRef8
Kathryn L. Ponder, Amy Salisbury, Bethany McGonnigal, Alyse Laliberte, Barry Lester, James F. Padbury. (2011) Maternal depression and anxiety are associated with altered gene expression in the human placenta without modification by antidepressant use: Implications for fetal programming. Developmental Psychobiology 53:7, 711-723
CrossRef9
Laura Lorenzo, Barbara Byers, Adrienne Einarson. (2011) Antidepressant use in pregnancy. Expert Opinion on Drug Safety 10:6, 883-889
CrossRef10
Luke E. Grzeskowiak, Andrew L. Gilbert, Janna L. Morrison. (2011) Investigating Outcomes Following the Use of Selective Serotonin Reuptake Inhibitors for Treating Depression in Pregnancy. Drug Safety 34:11, 1027-1048
CrossRef11
Madeleine A. Becker, Tal E. Weinberger, Lex Denysenko, Elisabeth J. S. Kunkel. 2011. Mood disorders. , 138-152.
CrossRef12
Stewart, Donna E., . (2011) Depression during Pregnancy. New England Journal of Medicine 365:17, 1605-1611
Full Text13
Regina C. Casper, Allyson A. Gilles, Barry E. Fleisher, Joan Baran, Gregory Enns, Laura C. Lazzeroni. (2011) Length of prenatal exposure to selective serotonin reuptake inhibitor (SSRI) antidepressants: effects on neonatal adaptation and psychomotor development. Psychopharmacology 217:2, 211-219
CrossRef14
Assia Miller, Tiffany Riehle-Colarusso, Csaba Siffel, Jaime L. Frías, Adolfo Correa. (2011) Maternal age and prevalence of isolated congenital heart defects in an urban area of the United States. American Journal of Medical Genetics Part A 155:9, 2137-2145
CrossRef15
Eduard J H Mulder, Frédérique FT Ververs, Roel de Heus, Gerard H A Visser. (2011) Selective Serotonin Reuptake Inhibitors Affect Neurobehavioral Development in the Human Fetus. Neuropsychopharmacology 36:10, 1961-1971
CrossRef16
Kimberly A. Yonkers, Simone Vigod, Lori E. Ross. (2011) Diagnosis, Pathophysiology, and Management of Mood Disorders in Pregnant and Postpartum Women. Obstetrics & Gynecology 118:3, 708-709
CrossRef17
Melissa A. Parisi, Catherine Y. Spong, Anne Zajicek, Alan E. Guttmacher. (2011) We don't know what we don't study: The case for research on medication effects in pregnancy. American Journal of Medical Genetics Part C: Seminars in Medical Genetics 157:3, 247-250
CrossRef18
Suzanne M. Gilboa, Cheryl S. Broussard, Owen J. Devine, Kara N. Duwe, Audrey L. Flak, Sheree L. Boulet, Cynthia A. Moore, Martha M. Werler, Margaret A. Honein. (2011) Influencing clinical practice regarding the use of antiepileptic medications during pregnancy: Modeling the potential impact on the prevalences of spina bifida and cleft palate in the United States. American Journal of Medical Genetics Part C: Seminars in Medical Genetics 157:3, 234-246
CrossRef19
Heli Malm, Miia Artama, Mika Gissler, Annukka Ritvanen. (2011) Selective Serotonin Reuptake Inhibitors and Risk for Major Congenital Anomalies. Obstetrics & Gynecology 118:1, 111-120
CrossRef20
Miia Artama, Mika Gissler, Heli Malm, Annukka Ritvanen, . (2011) Nationwide register-based surveillance system on drugs and pregnancy in Finland 1996-2006. Pharmacoepidemiology and Drug Safety 20:7, 729-738
CrossRef21
Sengwee Toh, Allen A. Mitchell, Marlene Anderka, Lolkje T.W. de Jong-van den Berg, Sonia Hernández-Díaz. (2011) Antibiotics and oral contraceptive failure — a case-crossover study. Contraception 83:5, 418-425
CrossRef22
Ariela Frieder. (2011) Antidepressant use during pregnancy. Expert Review of Obstetrics & Gynecology 6:3, 285-294
CrossRef23
Stephanie Gawlik, Corinna Reck. (2011) Erschöpfung und Depression in der Schwangerschaft. Psychotherapeut 56:3, 224-230
CrossRef24
Susan L. McElroy, Lesley M. Arnold, Lori L. Altshuler. 2011. Bipolarity in Women: Therapeutic Issues. , 317-350.
CrossRef25
Riccardo Davanzo, Marco Copertino, Angela De Cunto, Federico Minen, Alessandro Amaddeo. (2011) Antidepressant Drugs and Breastfeeding: A Review of the Literature. Breastfeeding Medicine 6:2, 89-98
CrossRef26
S. Gentile. (2011) Selective serotonin reuptake inhibitor exposure during early pregnancy and the risk of birth defects. Acta Psychiatrica Scandinavica 123:4, 266-275
CrossRef27
Bob Wilffert, Judith Altena, Laurien Tijink, Marleen MHJ van Gelder, Lolkje TW de Jong-van den Berg. (2011) Pharmacogenetics of drug-induced birth defects: what is known so far?. Pharmacogenomics 12:4, 547-558
CrossRef28
(2011) Embarazo y puerperio. FMC - Formación Médica Continuada en Atención Primaria 18, 9-52
CrossRef29
Lyn Colvin, Linda Slack-Smith, Fiona J. Stanley, Carol Bower. (2011) Dispensing patterns and pregnancy outcomes for women dispensed selective serotonin reuptake inhibitors in pregnancy. Birth Defects Research Part A: Clinical and Molecular Teratology 91:3, 142-152
CrossRef30
Christina D. Chambers. (2011) Value of the small cohort study including a physical examination for minor structural defects in identifying new human teratogens. Congenital Anomalies 51:1, 16-20
CrossRef31
Justin L. C. Bilszta, Shauna Tsuchiya, Kwiwon Han, Anne E. Buist, Adrienne Einarson. (2011) Primary care physician’s attitudes and practices regarding antidepressant use during pregnancy: a survey of two countries. Archives of Women's Mental Health 14:1, 71-75
CrossRef32
Shona Pfeiffer, Julia Boyle, Sean Daly, Eilís Dowd, Jana Haase, David McLaughlin. (2011) Human Amniocytes Regulate Serotonin Levels by Active Uptake and Express Genes Suggestive of a Wider Role in Facilitating Neurotransmitter Regulation in the Fetal Environment. Stem Cells and Development 20:2, 341-349
CrossRef33
Lewis B. Holmes. (2011) Human teratogens: Update 2010. Birth Defects Research Part A: Clinical and Molecular Teratology 91:1, 1-7
CrossRef34
Salvatore Gentile. (2011) Drug treatment for mood disorders in pregnancy. Current Opinion in Psychiatry 24:1, 34-40
CrossRef35
Shinji Kusakawa, Kazuaki Nakamura, Yuki Miyamoto, Atsushi Sanbe, Tomohiro Torii, Junji Yamauchi, Akito Tanoue. (2010) Fluoxetine promotes gliogenesis during neural differentiation in mouse embryonic stem cells. Journal of Neuroscience Research 88:16, 3479-3487
CrossRef36
M. Soufia, J. Aoun, M.-A. Gorsane, M.-O. Krebs. (2010) ISRS et grossesse : revue de la littérature. L'Encéphale 36:6, 513-516
CrossRef37
Polina Frolov, Jasem Alali, Michael D. Klein. (2010) Clinical risk factors for gastroschisis and omphalocele in humans: a review of the literature. Pediatric Surgery International 26:12, 1135-1148
CrossRef38
O. Chatillon, C. Even. (2010) La dépression de l’antepartum : prévalence, diagnostic, traitement. L'Encéphale 36:6, 443-451
CrossRef39
Pasternak, Björn, Hviid, Anders, . (2010) Use of Proton-Pump Inhibitors in Early Pregnancy and the Risk of Birth Defects. New England Journal of Medicine 363:22, 2114-2123
Full Text40
Deborah Kennedy, Adrienne Einarson. (2010) To the Editors. American Journal of Obstetrics and Gynecology 203:4, e12
CrossRef41
Samuel Bauer, Catherine Monk, Mark Ansorge, Cynthia Gyamfi, Michael Myers. (2010) Impact of antenatal selective serotonin reuptake inhibitor exposure on pregnancy outcomes in mice. American Journal of Obstetrics and Gynecology 203:4, 375.e1-375.e4
CrossRef42
Robert Keers, Katherine J. Aitchison. (2010) Gender differences in antidepressant drug response. International Review of Psychiatry 22:5, 485-500
CrossRef43
M. Reis, B. Källén. (2010) Delivery outcome after maternal use of antidepressant drugs in pregnancy: an update using Swedish data. Psychological Medicine 40:10, 1723-1733
CrossRef44
Marian K. Bakker, Hermien E. K. De Walle, Bob Wilffert, Lolkje T. W. de Jong-Van Den Berg. (2010) Fluoxetine and infantile hypertrophic pylorus stenosis: a signal from a birth defects-drug exposure surveillance study. Pharmacoepidemiology and Drug Safety 19:8, 808-813
CrossRef45
Katherine L. Wisner. (2010) SSRI treatment during pregnancy: are we asking the right questions?. Depression and Anxiety 27:8, 695-698
CrossRef46
Susan B. Brogly, Mark J. Abzug, D. Heather Watts, Coleen K. Cunningham, Paige L. Williams, James Oleske, Daniel Conway, Rhoda S. Sperling, Hans Spiegel, Russell B. Van Dyke. (2010) Birth Defects Among Children Born to Human Immunodeficiency Virus-Infected Women. The Pediatric Infectious Disease Journal 29:8, 721-727
CrossRef47
Sura Alwan, Jennita Reefhuis, Lorenzo D. Botto, Sonja A. Rasmussen, Adolfo Correa, Jan M. Friedman. (2010) Maternal use of bupropion and risk for congenital heart defects. American Journal of Obstetrics and Gynecology 203:1, 52.e1-52.e6
CrossRef48
Orit Avni-Barron, Kelly Hoagland, Christina Ford, Laura J Miller. (2010) Preconception planning to reduce the risk of perinatal depression and anxiety disorders. Expert Review of Obstetrics & Gynecology 5:4, 421-435
CrossRef49
Chantal Farra, Khalid Yunis, Mohammad Mikati, Nadine Yazbeck, Marianne Majdalani, Johnny Awwad. (2010) Goldenhar syndrome associated with prenatal maternal Fluoxetine ingestion: Cause or coincidence?. Birth Defects Research Part A: Clinical and Molecular Teratology 88:7, 582-585
CrossRef50
M. M. H. J. van Gelder, I. A. L. M. van Rooij, R. K. Miller, G. A. Zielhuis, L. T. W. de Jong-van den Berg, N. Roeleveld. (2010) Teratogenic mechanisms of medical drugs. Human Reproduction Update 16:4, 378-394
CrossRef51
Christopher Tjoa, Emmanuelle Pare, Deborah R Kim. (2010) Unipolar depression during pregnancy: nonpharmacologic treatment options. Women's Health 6:4, 565-576
CrossRef52
Teri Pearlstein, Jami Star. 2010. Psychiatric Disorders in Pregnancy. , 524-552.
CrossRef53
S. Favrelière, A. Nourrisson, N. Jaafari, M.-C. Pérault Pochat. (2010) Traitement par inhibiteurs sélectifs de la recapture de la sérotonine de la dépression chez la femme enceinte : risques pour le fœtus et le nouveau-né. L'Encéphale 36, D133-D138
CrossRef54
Lee S. Cohen, Betty Wang, Ruta Nonacs, Adele C. Viguera, Elizabeth L. Lemon, Marlene P. Freeman. (2010) Treatment of Mood Disorders During Pregnancy and Postpartum. Psychiatric Clinics of North America 33:2, 273-293
CrossRef55
A. Bader, U. Frisch, A. Wirz-Justice, A. Riecher-Rössler. (2010) Schwangerschaftsdepression und deren Behandlung. Der Nervenarzt 81:3, 267-276
CrossRef56
Keele E. Wurst, Charles Poole, Sara A. Ephross, Andrew F. Olshan. (2010) First trimester paroxetine use and the prevalence of congenital, specifically cardiac, defects: A meta-analysis of epidemiological studies. Birth Defects Research Part A: Clinical and Molecular Teratology 88:3, 159-170
CrossRef57
Pooja Bansil, Elena V. Kuklina, Susan F. Meikle, Samuel F. Posner, Athena P. Kourtis, Sascha R. Ellington, Denise J. Jamieson. (2010) Maternal and Fetal Outcomes Among Women with Depression. Journal of Women's Health 19:2, 329-334
CrossRef58
Norio Watanabe, Ichiro M. Omori, Atsuo Nakagawa, Andrea Cipriani, Corrado Barbui, Hugh McGuire, Rachel Churchill, Toshi A. Furukawa. (2010) Safety Reporting and Adverse-Event Profile of Mirtazapine Described in Randomized Controlled Trials in Comparison with Other Classes of Antidepressants in the Acute-Phase Treatment of Adults with Depression. CNS Drugs 24:1, 35-53
CrossRef59
Anthony R. Scialli. (2010) Paroxetine exposure during pregnancy and cardiac malformations. Birth Defects Research Part A: Clinical and Molecular TeratologyNA-NA
CrossRef60
Marlene P. Freeman, Melinda F. Davis. (2010) Supportive psychotherapy for perinatal depression: preliminary data for adherence and response. Depression and Anxiety 27:1, 39-45
CrossRef61
Sengwee Toh, Allen A. Mitchell, Carol Louik, Martha M. Werler, Christina D. Chambers, Sonia Hernández-Díaz. (2009) Antidepressant Use During Pregnancy and the Risk of Preterm Delivery and Fetal Growth Restriction. Journal of Clinical Psychopharmacology 29:6, 555-560
CrossRef62
Maria Muzik, Sheila M. Marcus, Julie E. Heringhausen, Heather Flynn. (2009) When Depression Complicates Childbearing: Guidelines for Screening and Treatment During Antenatal and Postpartum Obstetric Care. Obstetrics and Gynecology Clinics of North America 36:4, 771-788
CrossRef63
Leonardus WJE Beurskens, Dick Tibboel, Régine PM Steegers-Theunissen. (2009) Role of nutrition, lifestyle factors, and genes in the pathogenesis of congenital diaphragmatic hernia: human and animal studies. Nutrition Reviews 67:12, 719-730
CrossRef64
TF Ververs, K van Wensen, MW Freund, M van der Heide, GHA Visser, AFAM Schobben, LTW de Jong-van den Berg, ACG Egberts. (2009) Association between antidepressant drug use during pregnancy and child healthcare utilisation. BJOG: An International Journal of Obstetrics & Gynaecology 116:12, 1568-1577
CrossRef65
Gin S. Malhi, Danielle Adams, Catherine M. Cahill, Seetal Dodd, Michael Berk. (2009) The Management of Individuals with Bipolar Disorder. Drugs 69:15, 2063-2101
CrossRef66
Paul Merlob, Einat Birk, Lea Sirota, Nehama Linder, Michael Berant, Bracha Stahl, Gil Klinger. (2009) Are selective serotonin reuptake inhibitors cardiac teratogens? Echocardiographic screening of newborns with persistent heart murmur. Birth Defects Research Part A: Clinical and Molecular Teratology 85:10, 837-841
CrossRef67
Willem N. Sloot, H. Clare Bowden, Tjong D. Yih. (2009) In vitro and in vivo reproduction toxicology of 12 monoaminergic reuptake inhibitors: Possible mechanisms of infrequent cardiovascular anomalies. Reproductive Toxicology 28:2, 270-282
CrossRef68
Kimberly A. Yonkers, Katherine L. Wisner, Donna E. Stewart, Tim F. Oberlander, Diana L. Dell, Nada Stotland, Susan Ramin, Linda Chaudron, Charles Lockwood. (2009) The management of depression during pregnancy: a report from the American Psychiatric Association and the American College of Obstetricians and Gynecologists. General Hospital Psychiatry 31:5, 403-413
CrossRef69
J. M. Friedman. (2009) Big risks in small groups: The difference between epidemiology and counselling. Birth Defects Research Part A: Clinical and Molecular Teratology 85:8, 720-724
CrossRef70
Serena Belli, Silvia Mazzola, Roberto Luongo, Luca Barcella, Brunilda Alushi, Alessia Favaro, Matteo Bertelli. (2009) Genetic counseling for teratogenic risk due to exposure to medications: 89 pregnancies conceived during oral contraceptive use. American Journal of Medical Genetics Part A 149A:7, 1555-1557
CrossRef71
Kathleen Courtney. (2009) Use of SSRIs in Pregnancy: Neonatal Implications. Nursing for Women's Health 13:3, 234-238
CrossRef72
Jillan Cantor Sackett, Ronald A. Weller, Elizabeth B. Weller. (2009) Selective serotonin reuptake inhibitor use during pregnancy and possible neonatal complications. Current Psychiatry Reports 11:3, 253-257
CrossRef73
Lakshmi N Yatham, Sidney H Kennedy, Ayal Schaffer, Sagar V Parikh, Serge Beaulieu, Claire O'Donovan, Glenda MacQueen, Roger S McIntyre, Verinder Sharma, Arun Ravindran, L Trevor Young, Allan H Young, Martin Alda, Roumen Milev, Eduard Vieta, Joseph R Calabrese, Michael Berk, Kyooseob Ha, Flávio Kapczinski. (2009) Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) collaborative update of CANMAT guidelines for the management of patients with bipolar disorder: update 2009. Bipolar Disorders 11:3, 225-255
CrossRef74
Sura Alwan, Jan M. Friedman. (2009) Safety of Selective Serotonin Reuptake Inhibitors in Pregnancy. CNS Drugs 23:6, 493-509
CrossRef75
Susan E. Andrade, Heather McPhillips, David Loren, Marsha A. Raebel, Kimberly Lane, James Livingston, Denise M. Boudreau, David H. Smith, Robert L. Davis, Mary E. Willy, Richard Platt. (2009) Antidepressant medication use and risk of persistent pulmonary hypertension of the newborn. Pharmacoepidemiology and Drug Safety 18:3, 246-252
CrossRef76
Ha T. T. Nguyen, Verinder Sharma, Roger S. McIntyre. (2009) Teratogenesis associated with antibipolar agents. Advances in Therapy 26:3, 281-294
CrossRef77
Sheila M. Marcus, Julie E. Heringhausen. (2009) Depression in Childbearing Women: When Depression Complicates Pregnancy. Primary Care: Clinics in Office Practice 36:1, 151-165
CrossRef78
Kimberly K. McClanahan. (2009) Depression in Pregnant Adolescents: Considerations for Treatment. Journal of Pediatric and Adolescent Gynecology 22:1, 59-64
CrossRef79
SHMUEL DAVIDSON, DIANA PROKONOV, MICHAL TALER, RACHEL MAAYAN, DANIELLA HARELL, IRIT GIL-AD, ABRAHAM WEIZMAN. (2009) Effect of Exposure to Selective Serotonin Reuptake Inhibitors In Utero on Fetal Growth: Potential Role for the IGF-I and HPA Axes. Pediatric Research 65:2, 236-241
CrossRef80
Anick Bérard. (2009) Paroxetine exposure during pregnancy and the risk of cardiac malformations: What is the evidence?. Birth Defects Research Part A: Clinical and Molecular TeratologyNA-NA
CrossRef81
Megan Galbally, Andrew J. Lewis, Jarrad Lum, Anne Buist. (2009) Serotonin discontinuation syndrome following in utero exposure to antidepressant medication: prospective controlled study. Australian and New Zealand Journal of Psychiatry 43:9, 846-854
CrossRef82
Marco Tuccori, Arianna Testi, Luca Antonioli, Matteo Fornai, Sabrina Montagnani, Narcisa Ghisu, Rocchina Colucci, Tiberio Corona, Corrado Blandizzi, Mario Del Tacca. (2009) Safety concerns associated with the use of serotonin reuptake inhibitors and other serotonergic/noradrenergic antidepressants during pregnancy: A review. Clinical Therapeutics 31, 1426-1453
CrossRef83
Ingela Danielsson, Laurence Lister. (2009) A pilot study of the teratogenicity of vagus nerve stimulation in a rabbit model. Brain Stimulation 2:1, 41-49
CrossRef84
Marian K. Bakker, Wilhelmina S. Kerstjens-Frederikse, Charles H. C. M. Buys, Hermien E. K. de Walle, Lolkje T. W. de Jong-van den Berg. (2009) First-trimester use of paroxetine and congenital heart defects: A population-based case-control study. Birth Defects Research Part A: Clinical and Molecular TeratologyNA-NA
CrossRef85
C. L. Wichman, K. M. Moore, T. R. Lang, J. L. St. Sauver, R. H. Heise, W. J. Watson. (2009) Congenital Heart Disease Associated With Selective Serotonin Reuptake Inhibitor Use During Pregnancy. Mayo Clinic Proceedings 84:1, 23-27
CrossRef86
David Healy. 2009. Les effets indésirables des antidépresseurs. , 71-86.
CrossRef87
Shinji Kusakawa, Junji Yamauchi, Yuki Miyamoto, Atsushi Sanbe, Akito Tanoue. (2008) Estimation of embryotoxic effect of fluoxetine using embryonic stem cell differentiation system. Life Sciences 83:25-26, 871-877
CrossRef88
Ariela Frieder, Anne L. Dunlop, Larry Culpepper, Peter S. Bernstein. (2008) The clinical content of preconception care: women with psychiatric conditions. American Journal of Obstetrics and Gynecology 199:6, S328-S332
CrossRef89
Christina L. Wichman, Amy Fothergill, Katherine M. Moore, Tara R. Lang, Robert H. Heise, William J. Watson. (2008) Recent Trends in Selective Serotonin Reuptake Inhibitor Use in Pregnancy. Journal of Clinical Psychopharmacology 28:6, 714-716
CrossRef90
John H. Coverdale, Laurence B. McCullough, Frank A. Chervenak. (2008) The Ethics of Randomized Placebo-Controlled Trials of Antidepressants With Pregnant Women. Obstetrics & Gynecology 112:6, 1361-1368
CrossRef91
Robin Fleschler, Melissa F. Peskin. (2008) Selective Serotonin Reuptake Inhibitors (SSRIs) in Pregnancy. MCN, The American Journal of Maternal/Child Nursing 33:6, 355-361
CrossRef92
Emily E. Petersen, Allen A. Mitchell, John C. Carey, Martha M. Werler, Carol Louik, Sonja A. Rasmussen, . (2008) Maternal exposure to statins and risk for birth defects: A case-series approach. American Journal of Medical Genetics Part A 146A:20, 2701-2705
CrossRef93
Marlene P. Freeman, Melinda Davis, Priti Sinha, Katherine L. Wisner, Joseph R. Hibbeln, Alan J. Gelenberg. (2008) Omega-3 fatty acids and supportive psychotherapy for perinatal depression: A randomized placebo-controlled study. Journal of Affective Disorders 110:1-2, 142-148
CrossRef94
Orna Diav-Citrin, Svetlana Shechtman, Dafna Weinbaum, Rebecka Wajnberg, Meytal Avgil, Elena Di Gianantonio, Maurizio Clementi, Corinna Weber-Schoendorfer, Christof Schaefer, Asher Ornoy. (2008) Paroxetine and fluoxetine in pregnancy: a prospective, multicentre, controlled, observational study. British Journal of Clinical Pharmacology
CrossRef95
Emily C. Dossett. (2008) Perinatal Depression. Obstetrics and Gynecology Clinics of North America 35:3, 419-434
CrossRef96
Jani Kaaro, Timo Partonen, Paulami Naik, Nouchine Hadjikhani. (2008) Is migraine a lateralization defect?. NeuroReport 19:13, 1351-1353
CrossRef97
Cabot, Richard C.Harris, Nancy Lee, Shepard, Jo-Anne O., Rosenberg, Eric S., Cort, Alice M., Ebeling, Sally H.Peters, Christine C., Viguera, Adele C., Emmerich, Anne D., Cohen, Lee S., . (2008) Case 24-2008. New England Journal of Medicine 359:5, 509-515
Full Text98
M. Florentin, E. N. Liberopoulos, M. S. Elisaf. (2008) Sibutramine-associated adverse effects: a practical guide for its safe use. Obesity Reviews 9:4, 378-387
CrossRef99
Catherine Monk, Kristin L. Leight, Yixin Fang. (2008) The relationship between women’s attachment style and perinatal mood disturbance: implications for screening and treatment. Archives of Women's Mental Health 11:2, 117-129
CrossRef100
DJ Newport, PA Brennan, P Green, D Ilardi, TH Whitfield, N Morris, BT Knight, ZN Stowe. (2008) Maternal depression and medication exposure during pregnancy: comparison of maternal retrospective recall to prospective documentation. BJOG: An International Journal of Obstetrics and Gynaecology 115:6, 681-688
CrossRef101
C. Paton. (2008) Prescribing in pregnancy. The British Journal of Psychiatry 192:5, 321-322
CrossRef102
E. Ramos, M. St-Andre, E. Rey, D. Oraichi, A. Berard. (2008) Duration of antidepressant use during pregnancy and risk of major congenital malformations. The British Journal of Psychiatry 192:5, 344-350
CrossRef103
Siu Wa Tang, Daiga Helmeste. (2008) Paroxetine. Expert Opinion on Pharmacotherapy 9:5, 787-794
CrossRef104
Naomi Schneid-Kofman, Eyal Sheiner, Amalia Levy. (2008) Psychiatric illness and adverse pregnancy outcome. International Journal of Gynecology & Obstetrics 101:1, 53-56
CrossRef105
Marian K. Bakker, Pieternel Kölling, Paul B. van den Berg, Hermien E. K. de Walle, Lolkje T. W. de Jong van den Berg. (2008) Increase in use of selective serotonin reuptake inhibitors in pregnancy during the last decade, a population-based cohort study from the Netherlands. British Journal of Clinical Pharmacology 65:4, 600-606
CrossRef106
BARBRA FISHER, NANCY C. ROSE, JOHN C. CAREY. (2008) Principles and Practice of Teratology for the Obstetrician. Clinical Obstetrics and Gynecology 51:1, 106-118
CrossRef107
Tim F. Oberlander, William Warburton, Shaila Misri, Wayne Riggs, Jaafar Aghajanian, Clyde Hertzman. (2008) Major congenital malformations following prenatal exposure to serotonin reuptake inhibitors and benzodiazepines using population-based health data. Birth Defects Research Part B: Developmental and Reproductive Toxicology 83:1, 68-76
CrossRef108
CD Chambers, JE Polifka, JM Friedman. (2008) Drug Safety in Pregnant Women and Their Babies: Ignorance Not Bliss. Clinical Pharmacology & Therapeutics 83:1, 181-183
CrossRef109
(2008) Current awareness: Pharmacoepidemiology and drug safety. Pharmacoepidemiology and Drug Safety 17:1, i-xii
CrossRef110
S Maschi, A Clavenna, R Campi, B Schiavetti, M Bernat, M Bonati. (2008) Neonatal outcome following pregnancy exposure to antidepressants: a prospective controlled cohort study. BJOG: An International Journal of Obstetrics & Gynaecology 115:2, 283-289
CrossRef111
Sophie Grigoriadis. (2008) Doctor please tell me what is best for me and my baby. Expert Review of Obstetrics & Gynecology 3:1, 5-7
CrossRef112
Elizabeth B. Andrews, Patricia Tennis. (2007) Promise and pitfalls of administrative data in evaluating pregnancy outcomes. Pharmacoepidemiology and Drug Safety 16:11, 1181-1183
CrossRef113
Alwan, Sura, Reefhuis, Jennita, Rasmussen, Sonja A., Olney, Richard S., Friedman, Jan M., . (2007) Use of Selective Serotonin-Reuptake Inhibitors in Pregnancy and the Risk of Birth Defects. New England Journal of Medicine 356:26, 2684-2692
Full Text114
Greene, Michael F., . (2007) Teratogenicity of SSRIs — Serious Concern or Much Ado about Little?. New England Journal of Medicine 356:26, 2732-2733
Full Text
