Exposure to selective noradrenalin reuptake inhibitors during the first trimester of pregnancy and risk of congenital malformations: A meta-analysis of cohort studies

Lou, Zhuoqi; Zhou, Yuanyue; Zhang, Xue; Jiang, Hai‐yin

doi:10.1016/j.psychres.2022.114756

Cited by 10 publications

(9 citation statements)

References 36 publications

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“…89 Furthermore, first trimester exposure to venlafaxine or duloxetine does not seem to be linked to cardiac malformations among pregnant individuals with a clinical indication for these medications. 89 Yet, there are some conflicting data suggesting that early in utero exposure to venlafaxine may raise cardiac malformation risk in addition to other types of birth defects after controlling for confounds. 90 Limited data exist on the teratogenicity of tricyclic antidepressants (TCAs), but 1 meta-analysis suggests that first trimester use of most TCAs (except clomipramine) may not be associated with congenital cardiac malformations.…”

Section: Congenital Malformationsmentioning

confidence: 98%

“…75 However, 1 recent population-based study suggest that gestational fluoxetine use may elevate the risk of minor cardiac malformations after statistically adjusting for confounds. 87 First trimester use of SNRIs may not be associated with an increased risk of most congenital malformations 89 except for cardiac defects. 76,89 However, this relationship with cardiac defects may not remain statistically significant when examined among pregnant individuals with a clinical indication for an SNRI.…”

Section: Congenital Malformationsmentioning

confidence: 99%

“…87 First trimester use of SNRIs may not be associated with an increased risk of most congenital malformations 89 except for cardiac defects. 76,89 However, this relationship with cardiac defects may not remain statistically significant when examined among pregnant individuals with a clinical indication for an SNRI. 89 Furthermore, first trimester exposure to venlafaxine or duloxetine does not seem to be linked to cardiac malformations among pregnant individuals with a clinical indication for these medications.…”

Section: Congenital Malformationsmentioning

confidence: 99%

“…76,89 However, this relationship with cardiac defects may not remain statistically significant when examined among pregnant individuals with a clinical indication for an SNRI. 89 Furthermore, first trimester exposure to venlafaxine or duloxetine does not seem to be linked to cardiac malformations among pregnant individuals with a clinical indication for these medications. 89 Yet, there are some conflicting data suggesting that early in utero exposure to venlafaxine may raise cardiac malformation risk in addition to other types of birth defects after controlling for confounds.…”

Section: Congenital Malformationsmentioning

confidence: 99%

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Perinatal Depression: A Guide to Detection and Management in Primary Care

Dama,

Van Lieshout

2023

J Am Board Fam Med

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Introduction: Existing guidelines for primary care clinicians (PCCs) on the detection and management of perinatal depression (PD) contain important gaps. This review aims to provide PCCs with a summary of clinically relevant evidence in the field.Methods: A narrative literature review was conducted by searching PubMed and PsycINFO for articles published between 2010 to 2023. Guidelines, systematic reviews, clinical trials, and/or observational studies were all examined.Results: Screening with the Edinburgh Postnatal Depression Scale or Patient Health Questionnaire-9 followed by a diagnostic evaluation for major depressive disorder in probable cases can enhance PD detection. At-risk individuals and mild to moderate PD should be referred for cognitive behavioral therapy or interpersonal psychotherapy when available. Selective serotonin reuptake inhibitors should be used for moderate to severe PD, with sertraline, escitalopram, or citalopram being preferred first. Using paroxetine or clomipramine in pregnancy, and fluoxetine or doxepin during lactation is generally not preferred. Gestational antidepressant use is associated with a small increase in risk of reduced gestational age at birth, low birth weight, and lower APGAR scores, though whether these links are causal is unclear. Sertraline and paroxetine have the lowest rate of adverse events during lactation. Consequences of untreated PD can include maternal and offspring mortality, perinatal complications, poor maternal-infant attachment, child morbidity and maltreatment, less breastfeeding, and offspring developmental problems.Conclusions: These clinically relevant data can support the delivery of high-quality care by PCCs. Risks and benefits of PD treatments and the consequences of untreated PD should be discussed with patients to support informed decision making. ( J Am Board Fam Med 2023;00:000-000.

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Section: Congenital Malformationsmentioning

confidence: 98%

Section: Congenital Malformationsmentioning

confidence: 99%

Section: Congenital Malformationsmentioning

confidence: 99%

Section: Congenital Malformationsmentioning

confidence: 99%

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Perinatal Depression: A Guide to Detection and Management in Primary Care

Dama,

Van Lieshout

2023

J Am Board Fam Med

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“…A 2022 meta-analysis of eight cohort studies (N=6,972,503) analyzed the association between serotonin norepinephrine reuptake inhibitor (SNRI) use and the incidence of congenital malformations. 1 The analysis included SNRI exposure (venlafaxine, duloxetine, and others not specified; dosing not provided) in the first trimester of pregnancy. This analysis excluded studies that did not have a control group.…”

mentioning

confidence: 99%

In pregnant women with a history of depression, does the use of a selective norepinephrine reuptake inhibitor during pregnancy increase the risk of congenital malformation compared with a selective serotonin reuptake inhibitor?

Abbs,

Goettel,

Haugh

et al. 2023

EBPR

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above. Patients were club soccer players between seven and 12 years from Switzerland, Germany, the Czech Republic, and the Netherlands. Patients were excluded if they already used a warm-up focused on neuromuscular control. Patients were randomized to either warm-up as usual (n51,829) or the FIFA 11+ Kids program (n52,066). It should be noted that the FIFA11+ Kids program contained some different elements than the basic FIFA 11+, which addressed developmental and age-appropriate motor skills. The primary outcome was the overall risk of injuries. Compared with the control group, the overall injury rate in the intervention group was reduced by 48% (hazard ratio [HR] 0.52; 95% CI, 0.3220.86). Injuries requiring greater than 28 days off (HR 0.26; 95% CI 0.1020.64) and lower extremity injuries (HR 0.45; 95% CI, 0.24-0.84) were also significantly lower in the intervention group. Limitations included a lower proportion of girls and difficulty in blinding participants.

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Psychopharmaka in Schwangerschaft und Stillzeit

Paulzen,

Benkert

2023

Kompendium Der Psychiatrischen Pharmakotherapie

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Exposure to selective noradrenalin reuptake inhibitors during the first trimester of pregnancy and risk of congenital malformations: A meta-analysis of cohort studies

Cited by 10 publications

References 36 publications

Perinatal Depression: A Guide to Detection and Management in Primary Care

Perinatal Depression: A Guide to Detection and Management in Primary Care

In pregnant women with a history of depression, does the use of a selective norepinephrine reuptake inhibitor during pregnancy increase the risk of congenital malformation compared with a selective serotonin reuptake inhibitor?

Psychopharmaka in Schwangerschaft und Stillzeit

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