First-Trimester Antidepressant Use Not Associated with Cardiac Defects — Physician’s First Watch
First-Trimester Antidepressant Use Not Associated with Cardiac Defects
By Deborah Cowley, MD
No increased risk was found between first-trimester use of antidepressants and cardiac abnormalities in an analysis published in the New England Journal of Medicine.
Researchers analyzed Medicaid data on roughly 950,000 females (aged 12–55) and their liveborn infants. During the first trimester, 6.8% used an antidepressant, more than two thirds of whom used selective serotonin reuptake inhibitors. Cardiac malformations were diagnosed in 90 per 10,000 antidepressant-exposed infants versus 72 per 10,000 unexposed infants.
Fully adjusted analyses restricted the cohort to women with depression and controlled for confounding factors, such as sociodemographics and multiple gestation. No association was found between overall antidepressant use and cardiac malformations. In addition, there was no association between paroxetine and right ventricular outflow tract obstruction or between sertraline and ventricular septal defects.
This very large study, which adjusted for important confounders, is reassuring in suggesting a lack of association between first-trimester antidepressant exposure and risk for cardiac defects.
Dr. Cowley is an associate editor for NEJM Journal Watch Psychiatry, from which this article was adapted.