HealthDay News — Selective serotonin-reuptake inhibitor (SSRI) and other antidepressant use in the first trimester is not associated with increased risk of congenital cardiac defects, according to a study published  in the New England Journal of Medicine.

Krista F. Huybrechts, Ph.D., from Brigham and Women’s Hospital in Boston, and colleagues examined the correlation between use of SSRIs and other anti-depressants during pregnancy with the risk of congenital cardiac defects. The risk of major cardiac defects was assessed in a cohort of 949,504 pregnant women.

The researchers found that the number of infants born with a cardiac defect was 72.3 per 10,000 among those not exposed to antidepressants, compared with 90.1 per 10,000 infants with exposure. With increasing levels of adjustment for confounding, the associations between antidepressant use and cardiac defects were attenuated. With use of SSRIs, the relative risk of any cardiac defect was 1.25 (95% confidence interval [CI], 1.13 to 1.38) in unadjusted analysis, compared with 1.12 (95% CI, 1.00 to 1.26) and 1.06 (95% CI, 0.93 to 1.22) in analysis restricted to women with depression, and in fully-adjusted analysis restricted to women with depression, respectively. Paroxetine use was not significantly associated with right ventricular outflow tract obstruction (relative risk, 1.07, 95% CI, 0.59 to 1.93), nor was sertraline use associated with ventricular septal defects (relative risk, 1.04; 95% CI, 0.76 to 1.41).

“Our results suggest that the use of antidepressants during the first trimester does not substantially increase the risk of specific cardiac defects,” the authors write.


  1. Huybrechts, KF, et al. N Engl J Med 2014; 370:2397-2407 DOI: 10.1056/NEJMoa1312828