Maternal Use of Specific Antidepressant Medications During Early Pregnancy and the Risk of Selected Birth Defects
Study (n=30,630 case mothers of infants with birth defects and 11,478 control mothers) found some links between maternal antidepressant use and specific birth defects, with some limited data suggesting venlafaxine associated with highest risk of defects.
Source:
JAMA Psychiatry
SPS commentary:
An editorial highlights that treatment decision-making requires balancing the risks and benefits of pharmacotherapy with the maternal and foetal risks of untreated mental illness. It points to growing awareness of the foetal and early life origins of mental health indicating the importance of prevention and early intervention to mitigate the consequences of maternal psychiatric illness during childbearing. It acknowledged that avoidance of medication is not an option for some women, but conceptualising the literature on the effect of both depression and antidepressant exposure during pregnancy requires an appreciation of their complex interrelated dimensions. It notes that the evidence accumulated over the past 2 decades points to the risk (if any) for birth defects associated with antidepressants to be acceptable compared with the risks of untreated or undertreated maternal depression. It calls for research to advance the sophistication of treatment decision-making.