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

  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},
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. 
Selective serotonin reuptake inhibitor exposure during early pregnancy and the risk of birth defects
  • S. Gentile
  • Medicine, Biology
    Acta psychiatrica Scandinavica
  • 2011
It is necessary to select serotonin reuptake inhibitor exposure during early pregnancy to reduce the risk of birth defects in women with high-risk pregnancies, according to Gentile S.
Prenatal exposure to serotonin reuptake inhibitors: a case report
Two premature twins were born to a woman who had used paroxetine during pregnancy for an anxiety-depression disorder, where they showed prolonged RDS, cardiovascular malformations, and facial dysmorphisms, which partially disappeared during the following weeks, although alterations of tone persisted even at discharge.
Is the exposure to antidepressant drugs in early pregnancy a risk factor for spontaneous abortion? A review of available evidences
SUMMARY Aim – To review studies conducted to establish the risk of spontaneous abortion (SA) in women exposed to anti-depressant drugs (ADs) during early pregnancy. Methods – By using different
Safety of Selective Serotonin Reuptake Inhibitors in Pregnancy
Pregnant women who require treatment for depression and their physicians often face a difficult choice regarding the use of SSRIs, as the possibility of such functional abnormalities is an additional concern.
Risk-benefit balance assessment of SSRI antidepressant use during pregnancy and lactation based on best available evidence – an update
In pregnant or lactating women who require a pharmacological treatment, SSRIs can still be considered as appropriate when effective as the abundant data support their relative safety.
Risk-benefit balance assessment of SSRI antidepressant use during pregnancy and lactation based on best available evidence
In women suffering from major depression and responding to a pharmacological treatment, introduction or continuation of an SSRI should be encouraged in order to prevent maternal complications and to preserve maternal–infant bonding.
More questions than answers! Clinical dilemmas in psychopharmacology in pregnancy and lactation
Clinical questions are presented considering the available literature on safety of psychotropics in pregnancy and lactation and the application of these recommendations into clinical practice appears to be complex.
Critical determinants of the risk-benefit assessment of antidepressants in pregnancy : pharmacokinetic, safety and economic considerations.
Factors that should be included in these analyses include the pharmacokinetics and pharmacodynamics of antidepressants in pregnancy and their maternal and fetal safety.
Does paroxetine cause cardiac malformations?
Depression in pregnant adolescents: considerations for treatment.
  • K. McClanahan
  • Medicine, Psychology
    Journal of pediatric and adolescent gynecology
  • 2009


Newer antidepressants in pregnancy and rates of major malformations: a meta‐analysis of prospective comparative studies
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.
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.
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.
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
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
Maternal exposure to antidepressants may be associated with increased risk for SA; however, depression itself cannot be ruled out.
SSRIs in Pregnancy and Lactation
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.