Serotonin reuptake inhibitors in pregnancy and the risk of major malformations: a systematic review

@article{Bellantuono2007SerotoninRI,
  title={Serotonin reuptake inhibitors in pregnancy and the risk of major malformations: a systematic review},
  author={Cesario Bellantuono and Giovanni Migliarese and Salvatore Gentile},
  journal={Human Psychopharmacology: Clinical and Experimental},
  year={2007},
  volume={22}
}
To review studies conducted to establish the risk of major congenital malformations in women exposed to serotonin reuptake inhibitors (SRIs) during the first trimester of pregnancy. 
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References

SHOWING 1-10 OF 54 REFERENCES
Newer antidepressants in pregnancy and rates of major malformations: a meta‐analysis of prospective comparative studies
TLDR
A large number of women of childbearing age suffer from depression and relatively little is known about the safety of antidepressant use during pregnancy, so it is necessary to select patients suitable for antidepressant use.
Pregnancy outcome following maternal use of the new selective serotonin reuptake inhibitors: a prospective controlled multicenter study.
TLDR
The new SSRIs, fluvoxamine, paroxetine, and sertraline, do not appear to increase the teratogenic risk when used in their recommended doses.
Selective serotonin reuptake inhibitors and adverse pregnancy outcomes.
Safety of selective serotonin reuptake inhibitors in pregnancy.
TLDR
The review tries to clarify the blurred aspects of the use of SSRI during pregnancy and to give sensible and up-to-dated guidelines for the treatment of psychiatric disorders with SSRIs during pregnancy.
Pregnancy outcome following gestational exposure to venlafaxine: a multicenter prospective controlled study.
TLDR
The results suggest that the use of venlafaxine during pregnancy does not increase the rates of major malformations above the baseline rate of 1%-3%.
The Safety of Newer Antidepressants in Pregnancy and Breastfeeding
TLDR
It is suggested that choosing to administer psychopharmacological treatment in pregnant or breastfeeding women with depression will result primarily from a careful evaluation of their psychopathological condition, and the degree of severity of maternal disease appears to represent the most relevant parameter to take this clinical decision.
Antidepressant Use during Pregnancy and the Rates of Spontaneous Abortions: A Meta-Analysis
TLDR
Maternal exposure to antidepressants may be associated with increased risk for SA; however, depression itself cannot be ruled out.
SSRIs in Pregnancy and Lactation
TLDR
The findings emerging from the reports are inconclusive and are not able to fully clarify the repercussions of maternal SSRI treatment on infants’ long-term neurocognitive development.
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