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According to a new research, taking Fluoxetine (Prozac) and Paroxetine (Paxil) during pregnancy can lead to congenital defects. Though the incidence of defects caused is small, but it is still there.

Use of Fluoxetine (Prozac) and Paroxetine (Paxil) during pregnancy can lead to congenital defects

Therefore, women taking these medicines as antidepressants have been advised to consult their doctors before their pregnancy.

The research was a retrospective cohort study based on national population-based registers (years 1996–2006) of births, congenital anomalies, and terminations of pregnancy because of severe fetal anomalies in Finland. The aim of the study was to find out how many of these birth defects were a result of exposure to selective serotonin reuptake inhibitors (SSRIs) during pregnancy. It reviewed the national data of about 635,583 births during the aforementioned period.

According to Dr. Heli Malm, who works at the Teratology Information Service in the Hospital District of Helsinki and Uusimaa, Finland, and is the lead author of the research, 105 out of 10,000 babies born to mothers taking fluoxetine, and 31 out of 10,000 babies from mothers taking paroxetine had birth defects. This is a relatively small risk. However, it is advisable to take SSRIs during pregnancy only when it is clearly indicated. But once it has been found that taking these medicines is necessary for the well being of the mother, then these medicines are relatively safe. This is because untreated depression can also pose danger to the maternal and fetal health. Women, in consultation with their physicians, can explore the option of switching over to some other medications to treat their depression during pregnancy.

Fluoxetine and Paroxetine have been associated with ventricular septal defects and right ventricular outflow defects respectively

It was found that taking fluoxetine during pregnancy can increase the risk of giving birth to babies with isolated ventricular septal defects (VSDs). VSD is a condition where there is a hole between the right and left ventricles of the heart leading to a mixing of the non- oxygenated and the oxygenated blood. It was found that 105 of the 10,000 babies borne to mothers who were taking fluoxetine had VSD as compared to only 49 babies borne to mothers who were not taking the drug.

Similarly, 31 out of 10,000 babies developed a right ventricular outflow defect when exposed to paroxetine during pregnancy, as compared to just 7 out of 10,000 of non exposed babies. Paroxetine in early pregnancy can lead to right ventricular outflow defect in the babies. It is a condition in which the outflow of blood from the right ventricle of the heart is affected.

Apart from these heart defects, exposure to SSRIs has also been found to be associated with neural tube defects. 22 of the 10,000 babies exposed to SSRIs during pregnancy were borne with neural tube defects as compared to 9 of 10,000 babies who were not exposed to these medicines. Another interesting finding of the research was that the babies exposed to SSRIs during pregnancy were also more likely to suffer from alcohol related disorders. The only plausible explanation to this finding is that women with depression are more likely to consume alcohol because of associated psychiatric problems.

  • “Selective Serotonin Reuptake Inhibitors and Risk for Major Congenital Anomalies” by Malm, Heli MD, PhD, Artama, Miia MSc, PhD, Gissler, Mika MSocSc, PhD, Ritvanen, Annukka MD, published in “Obstetrics and Gynecology” in July, 2011, accessed on July 15, 2011
  • Photo courtesy of Emuishere Peliculas on Flickr: