Sertraline use in the first trimester and risk of congenital anomalies: a systemic review and meta‐analysis of cohort studies

Abstract

This meta-analysis suggested that the use of sertraline use by pregnant women in the first trimester had an increased risk of cardiovascular-related malformations as well as atrial and/or ventricular septal defects in infants. Meanwhile, nonsignificant associations between sertraline use and other congenital anomalies were found. More cohort studies are warranted to provide detailed results of other congenital anomalies.

Fluoxetine and congenital malformations: a systematic review and meta‐analysis of cohort studies

“…Retrieved studies were excluded from our meta‐analysis if they met any of the following criteria : (1) letters, editorials, case reports, reviews, meta‐analyses, notes or studies conducted in animals; (2) used case–control, cross‐sectional or clinical trial designs; (3) defined the fluoxetine exposure period as the second and/or third trimester; (4) did not provide sufficient risk estimates (i.e., OR, risk ratio or relative risk) with 95% CI, or did not provide sufficient data to calculate risk estimates; or (5) were not published in English.…”

Evidence-based guidelines for the pharmacological treatment of schizophrenia: Updated recommendations from the British Association for Psychopharmacology

“…With respect to SSRIs, database studies that have not controlled for maternal depression have reported an increased risk of cardiac septal defects in neonates exposed to SSRIs in utero (Gao et al, 2018;Kallen and Otterblad, 2007;Shen et al, 2017), but for the majority of SSRIs this effect is no longer statistically significant when maternal depression (Gao et al, 2018;Huybrechts et al, 2014) and lifestyle risk factors are controlled for (Huybrechts et al, 2014); data relating to sertraline are insufficient to allow an effect to be excluded (Gao et al, 2018).…”

British Association for Psychopharmacology consensus guidance on the use of psychotropic medication preconception, in pregnancy and postpartum 2017

“…Subsequent studies have implicated other antidepressants, including all commonly used SSRIs and clomipramine (Reis and Kallen, 2010;Shen et al, 2016).…”