Table 3.
Adjusted odds ratios for major congenital anomalies in children with first-trimester exposure to unmedicated maternal depression and antidepressant medications (n = 349 127 children, 9397 with major congenital anomalies)
| Depression* | SSRIs alone | TCAs alone | SSRIs & TCAs** | |||||
|---|---|---|---|---|---|---|---|---|
| n = 13 432 | n = 7683 | n = 2428 | n = 290 | |||||
| aOR*** | 95% CI | aOR*** | 95% CI | aOR*** | 95% CI | aOR*** | 95% CI | |
| All MCAs combined | 1.07 | 0.96–1.18 | 1.01 | 0.88–1.17 | 1.09 | 0.87–1.38 | 1.02 | 0.50–2.06 |
| Heart | 1.10 | 0.91–1.33 | 1.14 | 0.89–1.45 | 1.03 | 0.65–1.63 | 0.85 | 0.21–3.42 |
| Limb | 1.03 | 0.81–1.31 | 0.88 | 0.62–1.25 | 1.04 | 0.61–1.77 | – | |
| Genital system | 1.25 | 0.98–1.60 | 0.71 | 0.46–1.08 | 0.81 | 0.41–1.63 | 1.67 | 0.41–6.79 |
| Urinary system | 1.10 | 0.79–1.54 | 1.20 | 0.79–1.82 | 1.46 | 0.76–2.83 | 2.75 | 0.68–11.05 |
| Chromosomal | 1.29 | 0.87–1.93 | 0.79 | 0.42–1.48 | 0.90 | 0.34–2.43 | – | |
| Orofacial cleft | 1.13 | 0.73–1.75 | 1.06 | 0.58–1.93 | 0.58 | 0.14–2.31 | – | |
| Nervous system | 1.23 | 0.81–1.86 | 1.39 | 0.82–2.34 | 1.86 | 0.88–3.92 | 4.57 | 1.10–19.06***** |
| Musculoskeletal system | 0.78 | 0.46–1.33 | 0.91 | 0.44–1.88 | 0.56 | 0.14–2.33 | 2.66 | 0.39–18.10 |
| Digestive system | 0.84 | 0.46–1.54 | 1.43 | 0.79–2.61 | 1.26 | 0.40–3.94 | – | |
| Eye | 0.70 | 0.36–1.38 | 0.82 | 0.36–1.86 | 1.68 | 0.63–4.50 | – | |
| Other anomalies**** | 1.21 | 0.69–2.13 | 1.30 | 0.61–2.77 | 0.83 | 0.19–3.58 | – | |
| Respiratory system | 0.57 | 0.23–1.38 | 1.56 | 0.77–3.15 | 2.50 | 0.93–6.69 | – | |
| Ear, face, and neck | 2.39 | 1.08–5.27****** | – | – | – | |||
| Abdominal wall | 0.53 | 0.13–2.17 | 1.41 | 0.43–4.59 | – | – | ||
Diagnosed in the mother in the year before conception up to the end of the first trimester, but with no antidepressant drug prescriptions.
Dual exposure to both drug classes in the first trimester of pregnancy.
Odds ratio compared with children born to mothers without clinically recognised depression, adjusted for maternal age at the end of pregnancy, year of childbirth, Townsend deprivation quintile, maternal smoking history, body mass index before pregnancy, and maternal diabetes, hypertension, asthma, and epilepsy in the year before conception or during pregnancy.
For example, asplenia, situs inversus, and skin disorders.
P = 0.037.
P = 0.031.