This 2018 peer reviewed article from BMC Medicine addressed the use of selective serotonin reuptake inhibitors during pregnancy. SSRIs have become a mainstay of treatment for depression, anxiety and other psychiatric conditions. Depression and anxiety are specifically associated with adverse maternal outcomes and health behaviors during pregnancy. This systematic review and meta-analysis was performed to investigate whether there is a relationship between maternal use of SSRIs during early pregnancy and congenital malformations in infants.
The authors systematically searched PubMed, Embase, Web of Science, and The Cochrane Library, and ultimately 29 cohort studies were included featuring over 9 million births. They found that overall, the use of SSRIs was associated with a generally small risk of congenital malformations and therefore concluded that there is lack of any substantial teratogenic effect of SSRIs. Patients should certainly be cautious in making a decision whether to continue or stop treatment during pregnancy, as stopping treatment could prove to be more harmful to the infant than continuing the SSRI. A significant strength of this study is its large sample size, however it was limited by the fact that most studies only included live births and did not include stillbirths/spontaneous abortions/induced abortions. The results of this study are clinically significant because it provides helpful information for pregnant patients and their healthcare providers in order to make informed decisions regarding their treatment plans.
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