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Antidepressant use during the gestational period is a controversial
To determine whether duration of antidepressant use during the first
trimester increases the risk of major congenital malformations in
offspring of women diagnosed with psychiatric disorders.
A case-control study was performed among women who had been pregnant
between January 1998 and December 2002. Data were obtained from a
Medication and Pregnancy registry, built by linking three databases from
the province of Quebec, and a self-administered questionnaire. Women
eligible for this study had to be 15–45 years old at the beginning of
pregnancy, have at least one diagnosis of psychiatric disorder before
pregnancy, have used antidepressants for ≥ 30 days in the year prior to
pregnancy and have a pregnancy ending with a delivery. Cases were defined
as any major congenital malformation diagnosed in the offspring's first
year of life. Odds ratios, adjusted for relevant confounders, were
estimated using logistic regression.
Among the 2329 women meeting the inclusion criteria, 189 (8.1%) infants
were born with a major congenital malformation. Duration of
antidepressant use during the first trimester of pregnancy was not
associated with an increased risk of major congenital malformations: 1–30
days v. 0 day, adjusted OR=1.23 (95% CI 0.77–1.98);
31–60 days v. 0 day, adjusted OR=1.03 (95% CI
0.63–1.69); ≥ 61 days v. 0 day, adjusted OR=0.92 (95% CI
These data do not support an association between duration of
antidepressant use during the first trimester of pregnancy and major
congenital malformations in the offspring of women with psychiatric
disorders. These findings should help clinicians decide whether to
continue antidepressant therapy during pregnancy.
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