Antidepressants Linked to Heart Defects in Newborns

Certain drugs increase the possibility of septal malformation, researchers find

By Amanda Gardner
HealthDay Reporter

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THURSDAY, Sept. 24 (HealthDay News) -- Women who take certain antidepressants during the first three months of pregnancy may have a slightly increased risk of giving birth to babies with heart defects.

Septal heart defects -- malformations in the wall separating the right side of the heart from the left -- were more common among women taking antidepressants in the first trimester, Danish researchers found. Some of these heart defects resolve on their own, while others require surgery.

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The risks were seen in sertraline (trade names Zoloft and Lustral) and in citalopram (Celexa), both of which belong to the class of medications known as selective serotonin reuptake inhibitors (SSRIs).

Women who took more than one SSRI early in their pregnancy had a fourfold higher risk of having babies with this problem, said the authors of a study appearing online Sept. 24 in BMJ.

Still, the authors said the absolute risk is relatively low: 246 women would have to take such medication in order to see one septal heart defect. And 62 mothers would have to take more than one SSRI to see a problem in one child.

"A potential association with malformations must be considered in the choice of treatment of depression during pregnancy," said Dr. Lars Henning Pedersen, lead author and a research assistant in the department of epidemiology at Aarhus University in Denmark. However, "if our data is correct, the absolute risk is low, which must be balanced against the potential substantial risk of under- or untreated depression during pregnancy."

Other experts agree. "Early exposure can slightly increase the risk of heart defects, but the overall risk is still very, very small," added Dr. Jennifer Wu, an obstetrician and gynecologist at Lenox Hill Hospital in New York City.

And discontinuing antidepressants also carries risks.

"The concern with pregnant women with depression, if you take them off their medication, they can have a relapse into severe depression and this could lead to self-destructive behaviors," Wu said.

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