Table 4.
Type of antidepressant use during pregnancy and the risk of major congenital malformations as well as organ-specific malformations in a cohort of depressed pregnant women
| Crude prevalence | Adjusted* prevalence | |
|---|---|---|
| Congenital malformations | OR (95% CI) | OR (95% CI) |
| Major congenital malformations overall | ||
| Non-exposed | 1.00 | 1.00 |
| Paroxetine | 1.39 (1.15 to 1.68) | 1.24 (0.99 to 1.55) |
| Sertraline | 1.13 (0.83 to 1.55) | 1.09 (0.80 to 1.50) |
| Citalopram[AQ3] | 1.41 (1.11 to 1.78) | 1.36 (1.08 to 1.73) |
| Fluoxetine | 0.83 (0.51 to 1.35) | 0.80 (0.49 to 1.31) |
| Fluvoxamine | 0.63 (0.23 to 1.75) | 0.63 (0.23 to 1.77) |
| Venlafaxine | 1.12 (0.89 to 1.41) | 1.10 (0.87 to 1.38) |
| Tricyclic antidepressants | 1.23 (0.91 to 1.67) | 1.16 (0.86 to 1.56) |
| Other antidepressants | 0.96 (0.61 to 1.52) | 0.93 (0.59 to 1.47) |
| Nervous system | ||
| Non-exposed | 1.00 | 1.00 |
| Paroxetine | 1.37 (0.75 to 2.49) | 1.34 (0.74 to 2.42) |
| Sertraline | 1.79 (0.73 to 4.38) | 1.72 (0.69 to 4.26) |
| Citalopram | 1.32 (0.57 to 3.02) | 1.28 (0.55 to 2.93) |
| Fluoxetine | 0.68 (0.10 to 4.80) | 0.64 (0.09 to 4.52) |
| Fluvoxamine | 2.39 (0.33 to 17.05) | 2.44 (0.33 to 18.11) |
| Venlafaxine | 1.20 (0.55 to 2.59) | 1.19 (0.55 to 2.58) |
| Tricyclic antidepressants | 0.68 (0.17 to 2.72) | 0.60 (0.15 to 2.38) |
| Other antidepressants | 1.34 (0.33 to 5.40) | 1.21 (0.30 to 4.89) |
| Eye, ear, face and neck | ||
| Non-exposed | 1.00 | 1.00 |
| Paroxetine | 0.76 (0.31 to 1.88) | 0.75 (0.30 to 1.86) |
| Sertraline | 0.47 (0.07 to 3.40) | 0.44 (0.06 to 3.18) |
| Citalopram | 1.18 (0.43 to 3.23) | 1.13 (0.41 to 3.09) |
| Fluoxetine | 0.91 (0.13 to 6.47) | 0.85 (0.12 to 5.94) |
| Venlafaxine | 0.70 (0.22 to 2.22) | 0.70 (0.22 to 2.19) |
| Tricyclic antidepressants | 2.74 (1.19 to 6.30) | 2.45 (1.05 to 5.72) |
| Other antidepressants | 1.80 (0.44 to 7.36) | 1.71 (0.41 to 7.15) |
| Circulatory system | ||
| Non-exposed | 1.00 | 1.00 |
| Paroxetine | 1.17 (0.83 to 1.65) | 1.13 (0.79 to 1.60) |
| Sertraline | 1.31 (0.75 to 2.30) | 1.25 (0.71 to 2.19) |
| Citalopram | 1.31 (0.84 to 2.06) | 1.27 (0.81 to 1.99) |
| Fluoxetine | 0.56 (0.18 to 1.76) | 0.52 (0.16 to 1.65) |
| Fluvoxamine | 2.06 (0.64 to 6.61) | 2.00 (0.62 to 6.47) |
| Venlafaxine | 0.78 (0.47 to 1.30) | 0.77 (0.46 to 1.27) |
| Tricyclic antidepressants | 1.04 (0.56 to 1.91) | 0.96 (0.52 to 1.77) |
| Other antidepressants | 0.94 (0.38 to 2.31) | 0.88 (0.36 to 2.13) |
| Respiratory system | ||
| Non-exposed | 1.00 | 1.00 |
| Paroxetine | 0.98 (0.43 to 2.23) | 0.95 (0.41 to 2.21) |
| Fluoxetine | 1.93 (0.47 to 7.90) | 1.93 (0.47 to 7.85) |
| Venlafaxine | 2.25 (1.13 to 4.50) | 2.17 (1.07 to 4.38) |
| Tricyclic antidepressants | 0.96 (0.24 to 3.91) | 0.90 (0.22 to 3.61) |
| Other antidepressants | 1.91 (0.47 to 7.82) | 1.79 (0.44 to 7.32) |
| Digestive system | ||
| Non-exposed | 1.00 | 1.00 |
| Paroxetine | 0.97 (0.55 to 1.71) | 0.96 (0.54 to 1.71) |
| Sertraline | 1.15 (0.47 to 2.83) | 1.13 (0.46 to 2.77) |
| Citalopram | 1.16 (0.57 to 2.37) | 1.13 (0.55 to 2.32) |
| Fluoxetine | 0.88 (0.22 to 3.58) | 0.87 (0.21 to 3.56) |
| Venlafaxine | 0.91 (0.45 to 1.85) | 0.89 (0.44 to 1.83) |
| Tricyclic antidepressants | 2.70 (1.49 to 4.89) | 2.55 (1.40 to 4.66) |
| Other antidepressants | 0.44 (0.06 to 3.10) | 0.42 (0.06 to 2.98) |
| Genital organs | ||
| Non-exposed | 1.00 | 1.00 |
| Paroxetine | 0.80 (0.42 to 1.53) | 0.79 (0.41 to 1.52) |
| Sertraline | 0.97 (0.35 to 2.72) | 0.90 (0.31 to 2.61) |
| Citalopram | 0.93 (0.41 to 2.13) | 0.86 (0.37 to 1.99) |
| Fluoxetine | 0.50 (0.07 to 3.45) | 0.50 (0.07 to 3.35) |
| Venlafaxine | 0.74 (0.30 to 1.81) | 0.69 (0.29 to 1.67) |
| Tricyclic antidepressants | 1.24 (0.51 to 3.01) | 1.12 (0.46 to 2.72) |
| Other antidepressants | 0.91 (0.23 to 3.58) | 0.83 (0.21 to 3.27) |
| Urinary system | ||
| Non-exposed | 1.00 | 1.00 |
| Paroxetine | 0.46 (0.19 to 1.13) | 0.47 (0.19 to 1.14) |
| Sertraline | 0.86 (0.27 to 2.73) | 0.86 (0.27 to 2.71) |
| Citalopram | 0.18 (0.03 to 1.28) | 0.18 (0.02 to 1.26) |
| Fluoxetine | 0.55 (0.08 to 3.94) | 0.56 (0.08 to 4.00) |
| Venlafaxine | 1.43 (0.75 to 2.73) | 1.43 (0.75 to 2.73) |
| Tricyclic antidepressants | 0.83 (0.26 to 2.60) | 0.80 (0.25 to 2.57) |
| Other antidepressants | 0.54 (0.08 to 3.91) | 0.54 (0.08 to 3.86) |
| Musculoskeletal system | ||
| Non-exposed | 1.00 | 1.00 |
| Paroxetine | 1.02 (0.75 to 1.37) | 1.01 (0.75 to 1.37) |
| Sertraline | 1.06 (0.64 to 1.76) | 1.03 (0.62 to 1.71) |
| Citalopram | 1.96 (1.44 to 2.68) | 1.92 (1.40 to 2.62) |
| Fluoxetine | 1.00 (0.49 to 2.04) | 0.99 (0.48 to 2.01) |
| Fluvoxamine | 0.88 (0.21 to 3.58) | 0.87 (0.21 to 3.57) |
| Venlafaxine | 1.32 (0.95 to 1.84) | 1.30 (0.93 to 1.80) |
| Tricyclic antidepressants | 0.88 (0.51 to 1.51) | 0.84 (0.49 to 1.44) |
| Other antidepressants | 0.85 (0.40 to 1.83) | 0.83 (0.39 to 1.80) |
| Cardiac malformations | ||
| Non-exposed | 1.00 | 1.00 |
| Paroxetine | 1.49 (1.11 to 2.00) | 1.45 (1.12 to 1.88) |
| Sertraline | 1.19 (0.63 to 2.25) | 1.14 (0.60 to 2.15) |
| Citalopram | 1.18 (0.71 to 1.97) | 1.15 (0.69 to 1.92) |
| Fluoxetine | 0.45 (0.11 to 1.82) | 0.42 (0.10 to 1.73) |
| Fluvoxamine | 2.45 (0.76 to 7.87) | 2.44 (0.75 to 7.95) |
| Venlafaxine | 0.81 (0.47 to 1.40) | 0.80 (0.47 to 1.38) |
| Tricyclic antidepressants | 1.12 (0.59 to 2.13) | 1.05 (0.55 to 1.99) |
| Other antidepressants | 0.89 (0.33 to 2.42) | 0.84 (0.31 to 2.27) |
| Ventricular/atrial septal defect | ||
| Non-exposed | 1.00 | 1.00 |
| Paroxetine | 1.43 (1.17 to 1.75) | 1.39 (1.00 to 1.93) |
| Sertraline | 1.36 (0.69 to 2.65) | 1.33 (0.68 to 2.60) |
| Citalopram | 1.41 (0.83 to 2.39) | 1.39 (0.82 to 2.36) |
| Fluoxetine | 0.57 (0.14 to 2.30) | 0.55 (0.14 to 2.27) |
| Fluvoxamine | 2.03 (0.49 to 8.36) | 2.10 (0.51 to 8.71) |
| Venlafaxine | 0.74 (0.39 to 1.39) | 0.73 (0.39 to 1.39) |
| Tricyclic antidepressants | 1.14 (0.56 to 2.32) | 1.10 (0.54 to 2.24) |
| Other antidepressants | 1.14 (0.42 to 3.08) | 1.11 (0.41 to 2.97) |
| Craniosynostosis | ||
| Non-exposed | 1.00 | 1.00 |
| Paroxetine | 1.44 (0.69 to 2.99) | 1.53 (0.72 to 3.25) |
| Sertraline | 2.24 (0.82 to 6.16) | 2.29 (0.83 to 6.36) |
| Citalopram | 3.89 (2.06 to 7.35) | 3.95 (2.08 to 7.52) |
| Fluoxetine | 1.07 (0.15 to 7.65) | 1.14 (0.16 to 8.21) |
| Venlafaxine | 1.38 (0.56 to 3.43) | 1.41 (0.57 to 3.52) |
| Tricyclic antidepressants | 1.06 (0.26 to 4.36) | 1.05 (0.25 to 4.37) |
| Other antidepressants | 1.05 (0.15 to 7.63) | 1.15 (0.16 to 8.42) |
Ventricular/atrial septal defects are a subset of cardiac malformations. Results are provided when defects were identified for the antidepressant type in the study population (if 0 outcome identified).
*Adjusted for maternal age, welfare status, diabetes, hypertension, asthma and other medication uses including benzodiazepines as well as healthcare usage in the year prior and during the first trimester. Significant prevalence OR were bolded.