Table 5.
Absolute risks (per 10 000 live births) and adjusted odds ratios for major congenital anomalies in children born to women exclusively prescribed specific SSRIs during the first trimester of pregnancy
| SSRIs during the first trimester of pregnancy* | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Fluoxetine | Citalopram | Paroxetine | Sertraline | Escitalopram | ||||||
| n = 3189 | n = 1946 | n = 1200 | n = 757 | n = 333 | ||||||
| n/10 000 | aOR (95% CI)** | n/10 000 | aOR (95% CI)** | n/10 000 | aOR (95% CI)** | n/10 000 | aOR (95% CI)** | n/10 000 | aOR (95% CI)** | |
| All MCAs combined | 241 | 0.91 (0.73–1.15) | 267 | 1.06 (0.80–1.40) | 300 | 1.08 (0.77–1.50) | 330 | 1.27 (0.85–1.89) | 210 | 0.85 (0.40–1.81) |
| Heart | 66 | 0.84 (0.55–1.30) | 87 | 1.13 (0.70–1.82) | 142 | 1.78 (1.09–2.88)**** | 119 | 1.52 (0.78–2.96) | 90 | 1.15 (0.36–3.65) |
| Limb | 44 | 0.89 (0.52–1.50) | 31 | 0.68 (0.30–1.53) | 50 | 0.92 (0.41–2.06) | 66 | 1.36 (0.57–3.28) | 30 | 0.69 (0.10–4.89) |
| Genital system | 16 | 0.38 (0.16–0.93)***** | 36 | 0.91 (0.43–1.93) | 42 | 0.97 (0.40–2.37) | 13 | 0.32 (0.04–2.40) | 30 | 0.80 (0.11–5.78) |
| Urinary system | 28 | 1.14 (0.59–2.19) | 51 | 2.07 (1.10–3.92)****** | 25 | 0.99 (0.32–3.10) | 13 | 0.54 (0.08–3.76) | 0 | – |
| Chromosomal | 6 | 0.38 (0.09–1.15) | 5 | 0.34 (0.05–2.37) | 17 | 0.91 (0.22–3.83) | 40 | 2.32 (0.74–7.27) | 0 | – |
| Orofacial cleft | 22 | 1.64 (0.78–3.45) | 15 | 1.14 (0.36–3.60) | 0 | – | 13 | 0.99 (0.14–6.96) | 0 | – |
| Nervous system | 25 | 1.77 (0.87–3.57) | 15 | 1.18 (0.37–3.71) | 0 | – | 26 | 1.79 (0.42–7.54) | 30 | 2.45 (0.34–17.48) |
| Musculoskeletal system | 13 | 1.01 (0.38–2.65) | 10 | 0.81 (0.11–5.99) | 8 | 0.56 (0.07–4.53) | 26 | 2.13 (0.51–8.90) | 0 | – |
| Digestive system | 13 | 1.26 (0.47–3.39) | 26 | 2.60 (1.07–6.32)******* | 0 | – | 26 | 2.69 (0.67–10.76) | 0 | – |
| Eye | 9 | 0.96 (0.30–3.05) | 5 | 0.55 (0.08–3.95) | 8 | 0.83 (0.12–5.76) | 0 | – | 30 | 3.23 (0.41–25.26) |
| Other anomalies*** | 9 | 1.26 (0.39–4.02) | 10 | 1.77 (0.43–7.18) | 0 | – | 13 | 1.84 (0.27–12.79) | 0 | – |
| Respiratorysystem | 13 | 1.90 (0.71–5.09) | 5 | 0.79 (0.11–5.69) | 8 | 1.25 (0.18–8.96) | 26 | 4.04 (1.00–16.27)******** | 0 | – |
| Ear, face, and neck | 0 | – | 0 | – | 0 | – | 0 | – | 0 | – |
| Abdominal wall | 3 | 1.14 (0.16–8.19) | 0 | – | 0 | – | 13 | 4.90 (0.67–36.01) | 0 | – |
Children born to women treated with each specific SSRI drug exclusively during the first trimester, excluding children born to women treated with fluvoxamine (22 women) or with more than one type of SSRI (236 women: 71% were co-prescribed with fluoxetine).
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 index, maternal smoking history, maternal 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 = 0.020.
P = 0.034.
P = 0.025.
P = 0.035.
P = 0.049.