Specific SSRIs and birth defects: Bayesian analysis to interpret new data in the context of previous reports.
BMJ
; 351: h3190, 2015 Jul 08.
Article
en En
| MEDLINE
| ID: mdl-26156519
ABSTRACT
OBJECTIVE:
To follow up on previously reported associations between periconceptional use of selective serotonin reuptake inhibitors (SSRIs) and specific birth defects using an expanded dataset from the National Birth Defects Prevention Study.DESIGN:
Bayesian analysis combining results from independent published analyses with data from a multicenter population based case-control study of birth defects.SETTING:
10 centers in the United States.PARTICIPANTS:
17,952 mothers of infants with birth defects and 9857 mothers of infants without birth defects, identified through birth certificates or birth hospitals, with estimated dates of delivery between 1997 and 2009. EXPOSURES Citalopram, escitalopram, fluoxetine, paroxetine, or sertraline use in the month before through the third month of pregnancy. Posterior odds ratio estimates were adjusted to account for maternal race/ethnicity, education, smoking, and prepregnancy obesity. MAIN OUTCOMEMEASURE:
14 birth defects categories that had associations with SSRIs reported in the literature.RESULTS:
Sertraline was the most commonly reported SSRI, but none of the five previously reported birth defects associations with sertraline was confirmed. For nine previously reported associations between maternal SSRI use and birth defect in infants, findings were consistent with no association. High posterior odds ratios excluding the null value were observed for five birth defects with paroxetine (anencephaly 3.2, 95% credible interval 1.6 to 6.2; atrial septal defects 1.8, 1.1 to 3.0; right ventricular outflow tract obstruction defects 2.4, 1.4 to 3.9; gastroschisis 2.5, 1.2 to 4.8; and omphalocele 3.5, 1.3 to 8.0) and for two defects with fluoxetine (right ventricular outflow tract obstruction defects 2.0, 1.4 to 3.1 and craniosynostosis 1.9, 1.1 to 3.0).CONCLUSIONS:
These data provide reassuring evidence for some SSRIs but suggest that some birth defects occur 2-3.5 times more frequently among the infants of women treated with paroxetine or fluoxetine early in pregnancy.
Texto completo:
1
Colección:
01-internacional
Asunto principal:
Complicaciones del Embarazo
/
Efectos Tardíos de la Exposición Prenatal
/
Anomalías Inducidas por Medicamentos
/
Inhibidores Selectivos de la Recaptación de Serotonina
/
Anomalías Cardiovasculares
/
Gastrosquisis
/
Depresión
Tipo de estudio:
Clinical_trials
/
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Adult
/
Female
/
Humans
/
Newborn
/
Pregnancy
País/Región como asunto:
America do norte
Idioma:
En
Revista:
BMJ
Asunto de la revista:
MEDICINA
Año:
2015
Tipo del documento:
Article
País de afiliación:
Estados Unidos