Selective Serotonin Reuptake Inhibitor (SSRI) Antidepressants in Pregnancy and Congenital Anomalies: Analysis of Linked Databases in Wales, Norway and Funen, Denmark
Publication Date
December 01, 2016
Authors
Sue Jordan, Joan K. Morris, Gareth I. Davies, David Tucker, et al
Volume
11
Issue
12
Pages
e0165122
DOI
https://dx.plos.org/10.1371/journal.pone.0165122
Publisher URL
http://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0165122
Scopus
84999635682
Mendeley
http://www.mendeley.com/research/selective-serotonin-reuptake-inhibitor-ssri-antidepressants-pregnancy-congenital-anomalies-analysis
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Mendeley | Further Information

{"title"=>"Selective Serotonin Reuptake Inhibitor (SSRI) antidepressants in pregnancy and congenital anomalies: Analysis of linked databases in Wales, Norway and Funen, Denmark", "type"=>"journal", "authors"=>[{"first_name"=>"Sue", "last_name"=>"Jordan", "scopus_author_id"=>"36484678300"}, {"first_name"=>"Joan K.", "last_name"=>"Morris", "scopus_author_id"=>"35477488500"}, {"first_name"=>"Gareth I.", "last_name"=>"Davies", "scopus_author_id"=>"7402854905"}, {"first_name"=>"David", "last_name"=>"Tucker", "scopus_author_id"=>"12787845100"}, {"first_name"=>"Daniel S.", "last_name"=>"Thayer", "scopus_author_id"=>"56011372000"}, {"first_name"=>"Johannes M.", "last_name"=>"Luteijn", "scopus_author_id"=>"54789830900"}, {"first_name"=>"Margery", "last_name"=>"Morgan", "scopus_author_id"=>"55245450200"}, {"first_name"=>"Ester", "last_name"=>"Garne", "scopus_author_id"=>"7003909015"}, {"first_name"=>"Anne V.", "last_name"=>"Hansen", "scopus_author_id"=>"55855433200"}, {"first_name"=>"Kari", "last_name"=>"Klungsøyr", "scopus_author_id"=>"54787707700"}, {"first_name"=>"Anders", "last_name"=>"Engeland", "scopus_author_id"=>"7003614018"}, {"first_name"=>"Breidge", "last_name"=>"Boyle", "scopus_author_id"=>"56400459200"}, {"first_name"=>"Helen", "last_name"=>"Dolk", "scopus_author_id"=>"55522682000"}], "year"=>2016, "source"=>"PLoS ONE", "identifiers"=>{"sgr"=>"84999635682", "pmid"=>"27906972", "pui"=>"613481193", "issn"=>"19326203", "scopus"=>"2-s2.0-84999635682", "doi"=>"10.1371/journal.pone.0165122"}, "id"=>"74ccd700-afc6-3dd9-aea7-70558d6ad66f", "abstract"=>"BACKGROUND: Hypothesised associations between in utero exposure to selective serotonin reuptake inhibitors (SSRIs) and congenital anomalies, particularly congenital heart defects (CHD), remain controversial. We investigated the putative teratogenicity of SSRI prescription in the 91 days either side of first day of last menstrual period (LMP).\\n\\nMETHODS AND FINDINGS: Three population-based EUROCAT congenital anomaly registries- Norway (2004-2010), Wales (2000-2010) and Funen, Denmark (2000-2010)-were linked to the electronic healthcare databases holding prospectively collected prescription information for all pregnancies in the timeframes available. We included 519,117 deliveries, including foetuses terminated for congenital anomalies, with data covering pregnancy and the preceding quarter, including 462,641 with data covering pregnancy and one year either side. For SSRI exposures 91 days either side of LMP, separately and together, odds ratios with 95% confidence intervals (ORs, 95%CI) for all major anomalies were estimated. We also explored: pausing or discontinuing SSRIs preconception, confounding, high dose regimens, and, in Wales, diagnosis of depression. Results were combined in meta-analyses. SSRI prescription 91 days either side of LMP was associated with increased prevalence of severe congenital heart defects (CHD) (as defined by EUROCAT guide 1.3, 2005) (34/12,962 [0.26%] vs. 865/506,155 [0.17%] OR 1.50, 1.06-2.11), and the composite adverse outcome of 'anomaly or stillbirth' (473/12962, 3.65% vs. 15829/506,155, 3.13%, OR 1.13, 1.03-1.24). The increased prevalence of all major anomalies combined did not reach statistical significance (3.09% [400/12,962] vs. 2.67% [13,536/506,155] OR 1.09, 0.99-1.21). Adjusting for socio-economic status left ORs largely unchanged. The prevalence of anomalies and severe CHD was reduced when SSRI prescriptions were stopped or paused preconception, and increased when >1 prescription was recorded, but differences were not statistically significant. The dose-response relationship between severe CHD and SSRI dose (meta-regression OR 1.49, 1.12-1.97) was consistent with SSRI-exposure related risk. Analyses in Wales suggested no associations between anomalies and diagnosed depression.\\n\\nCONCLUSION: The additional absolute risk of teratogenesis associated with SSRIs, if causal, is small. However, the high prevalence of SSRI use augments its public health importance, justifying modifications to preconception care.", "link"=>"http://www.mendeley.com/research/selective-serotonin-reuptake-inhibitor-ssri-antidepressants-pregnancy-congenital-anomalies-analysis", "reader_count"=>26, "reader_count_by_academic_status"=>{"Unspecified"=>1, "Professor > Associate Professor"=>1, "Librarian"=>1, "Researcher"=>4, "Student > Doctoral Student"=>1, "Student > Ph. D. Student"=>2, "Student > Postgraduate"=>2, "Other"=>6, "Student > Master"=>5, "Student > Bachelor"=>3}, "reader_count_by_user_role"=>{"Unspecified"=>1, "Professor > Associate Professor"=>1, "Librarian"=>1, "Researcher"=>4, "Student > Doctoral Student"=>1, "Student > Ph. D. Student"=>2, "Student > Postgraduate"=>2, "Other"=>6, "Student > Master"=>5, "Student > Bachelor"=>3}, "reader_count_by_subject_area"=>{"Unspecified"=>3, "Environmental Science"=>1, "Biochemistry, Genetics and Molecular Biology"=>3, "Nursing and Health Professions"=>1, "Medicine and Dentistry"=>13, "Arts and Humanities"=>1, "Neuroscience"=>1, "Psychology"=>3}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>13}, "Neuroscience"=>{"Neuroscience"=>1}, "Psychology"=>{"Psychology"=>3}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>1}, "Biochemistry, Genetics and Molecular Biology"=>{"Biochemistry, Genetics and Molecular Biology"=>3}, "Unspecified"=>{"Unspecified"=>3}, "Environmental Science"=>{"Environmental Science"=>1}, "Arts and Humanities"=>{"Arts and Humanities"=>1}}, "group_count"=>4}

Scopus | Further Information

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