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Journal Article Annotations
2020, 3rd Quarter
Annotations by Priya Gopalan, MD
July, 2020
PUBLICATION #1 — Women’s Health
The finding:
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.
Relevance:
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):
Multi-center case-control