Table 6.

Adjusted odds ratios for major congenital anomalies in children with first-trimester exposure to different antidepressant medications, compared with children of women with unmedicated depression (n = 23 833 children, 666 with major congenital anomalies)

	SSRIs alone		TCAs alone		SSRIs & TCAs*		Fluoxetine alone		Citalopram alone		Paroxetine alone		Sertraline alone		Escitalopram alone
	n = 7683		n = 2428		n = 290		n = 3189		n = 1946		n = 1200		n = 757		n = 333
	aOR**	95% CI	aOR**	95% CI	aOR**	95% CI	aOR**	95% CI	aOR**	95% CI	aOR**	95% CI	aOR**	95% CI	aOR**	95% CI
All MCAs	0.93	0.78–1.11	1.02	0.79–1.32	0.94	0.46–1.92	0.85	0.66–1.09	0.97	0.71–1.31	1.01	0.71–1.44	1.17	0.78–1.77	0.77	0.36–1.66
Heart	1.04	0.76–1.41	0.90	0.54–1.50	0.78	0.19–3.27	0.79	0.49–1.26	1.02	0.61–1.70	1.67	1.00–2.80***	1.39	0.70–2.74	1.09	0.34–3.50
Limb	0.82	0.54–1.25	1.08	0.60–1.93	–		0.83	0.47–1.49	0.59	0.26–1.37	0.94	0.41–2.15	1.29	0.52–3.20	0.58	0.08–4.11
Genital system	0.57	0.35–0.92****	0.62	0.29–1.30	1.35	0.33–5.50	0.31	0.12–0.76	0.71	0.32–1.56	0.81	0.32–2.02	0.26	0.04–1.87	0.57	0.08–4.17

^*Dual exposure to both drug classes in the first trimester of pregnancy.

^**Odds ratio compared with children born to mothers with depression unmedicated with antidepressants in the first trimester, 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.

^***P = 0.051.

^****P = 0.024.