Journal Article Annotations
2020, 3rd Quarter
Annotations by Priya Gopalan, MD
PUBLICATION #1 — Women’s Health
This study utilized a case-control format to compare babies with congenital birth defects to those without in order to assess whether antidepressant use was associated with specific defects. Women were interviewed 6-24 weeks after delivery to determine if they took an antidepressant during pregnancy. Women who reported antidepressant use (n=1562 were compared to 467 mothers in the control group. The authors found a higher odds ratio of congenital heart defects for some antidepressants; the association was strongest for venlafaxine. However, many of these associations were reduced or disappeared after correcting for confounding factors and underlying psychiatric illness.
Strength and weaknesses:
Strengths of this study are the large database that was used and the clinical relevance of the topic. Weaknesses are considerable: there was considerable recall bias related to interviewing mothers post-delivery for early pregnancy antidepressant use after delivering a baby with a birth defect. The case control format also limits definitive conclusions. Additionally, once corrected for confounding factors, any associations found largely became insignificant.
The study is clinically relevant but does not counter the significant body of literature that indicates that SSRI/SNRI during pregnancy conveys no teratogenic risk.
Type of study (http://ebm.bmj.com/content/early/2016/06/23/ebmed-2016-110401):