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Study Shows SSRI Use during Pregnancy Doubles Risk of Birth Defects

Posted in Misc. Drugs, Paxil Birth Defects, Prozac Birth Defects, Zoloft Birth Defects

Published in a 2011 edition of the medical journal Obstetrics and Gynecology, a study by Dr. Heli Malm (et al.) evaluated the risk of birth defects for children born to mothers who used selective serotonin-reuptake inhibitors (a type of antidepressant medication) during pregnancy.  Drugs whose danger was evaluated included fluoxetine (Prozac®, Sarafem®, Fontex®, and others), paroxetine (Paxil®, Aropax®, Pexeva®, Seroxat®, and Sereupin®), and citalopram (Celexa®, Cipramil®).  The results were truly shocking.

Prozac® Birth Defects

Children born to mothers who used fluoxetine during pregnancy were found to be at twice the risk for ventricular septal defects (VSD) than were other children.[1]  While the background risk for a VSD is low (about 0.5% of all newborns[2]), any increased risk for this ailment is a very serious problem.  A ventricular septal defect means that the hole between the right and left ventricles of the heart that normally exists before birth does not close by the time the child is born.  Though most of the time, small VSDs close shortly after birth, larger ones may require heart surgery in the newborn.

Left untreated, a large VSD may result in poor brain grown or development,[3] and according to the medical encyclopedia MedlinePlus, a service of the National Library of Medicine and the National Institutes of Health, a large VSD may be complicated by:

  • “Aortic insufficiency (leaking of the valve that separates the left ventricle from the aorta)
  • Damage to the electrical conduction system of the heart during surgery (causing an irregular heart rhythm)
  • Delayed growth and development (failure to thrive in infancy)
  • Heart failure
  • Infective endocarditis (bacterial infection of the heart)
  • Pulmonary hypertension (high blood pressure in the lungs) leading to failure of the right side of the heart”[4]

Read more on this birth defect caused by SSRI use during pregnancy here.

Paxil® Birth Defects

Mothers who used paroxetine during pregnancy were found to unknowingly place their newborns at more than four times the risk than other newborns for being born with a right ventricle outflow tract defect.[5]

Defects in the right ventricle outflow tract usually consist in an obstruction of the right ventricle outflow tract, resulting in a decrease in the amount of blood able to reach the lungs, where it is filled with oxygen to be used in organs throughout the body.  The danger that results from a right ventricle outflow tract defect ranges with the severity of the defect.  Defects may go unnoticed and not change the patient’s quality of life, defects require heart surgery, and in some cases, defects can be fatal.

Celexa® Birth Defects

Finally, this study found that infants whose mothers used citalopram during pregnancy had more than twice the risk of being born with neural tube defects than were infants whose mothers did not use any antidepressant medications during pregnancy.[6]

The neural tube is a “tubular structure that results from the folding of tissue along the back of vertebrate embryos and develops into the brain and spinal cord,”[7]  and defects of the neural tube can refer to a variety of conditions, including spina bifida[8] and anencephaly.[9]

Spina bifida is a condition that occurs if “the fetal spinal column doesn’t close completely during the first month of pregnancy,”[10] resulting in “nerve damage that causes at least some paralysis.”[11]  Children with spina bifida may have trouble learning, “urinary and bowel problems or hydrocephalus, a buildup of fluid in the brain.”[12]

Sadly, like many neurological disorders, there is no cure for spina bifida.

Anencephaly, another terrible congenital disorder that can be caused by a neural tube defect, is a condition in which much of a fetus’s brain does not develop, resulting in still birth or death shortly after birth.  While there is no cure for this ailment, it is very rare in the general population.  However, any means of reducing the change that one’s child will be born with anencephaly should be taken – specifically, the cessation of SSRI drugs during pregnancy.


[1] Malm, H., et al. (2011) “Selective Serotonin Reuptake Inhibitors and Risk for Major Congenital Anomalies” Obstet Gynecol Vol. 118, No. 1; p. 111-120

[2] “Ventricular Septal Defect” Health Topics © 1999-2013 Cincinnati Children’s Hospital Medical Center available at <http://www.cincinnatichildrens.org/health/v/vsd/> accessed 16 January 2013

[3] Ibid.                                                                                                                                                                 

[4] “Ventricular Septal Defect: MedlinePlus Medical Encyclopedia” MedlinePlus, U.S. National Library of Medicine, National Institutes of Health. © 1997-2013, A.D.A.M. available at <http://www.nlm.nih.gov/medlineplus/ency/article/001099.htm> page updated 27 December 2012, accessed 16 January 2013

[5] Malm, H., et al. (2011) “Selective Serotonin Reuptake Inhibitors and Risk for Major Congenital Anomalies” Obstet Gynecol Vol. 118, No. 1; p. 111-120

[6] Malm, H., et al. (2011) “Selective Serotonin Reuptake Inhibitors and Risk for Major Congenital Anomalies” Obstet Gynecol Vol. 118, No. 1; p. 111-120

[7] “Neural Tube” The American Heritage® Science Dictionary © 2000 Houghton Mifflin Company available at <http://www.thefreedictionary.com/neural+tube> updated 2009, accessed 16 January 2013

[8] Ibid.

[9] “Neural Tube Defects: MedlinePlus” MedlinePlus, U.S. National Library of Medicine, National Institutes of Health. available at <http://www.nlm.nih.gov/medlineplus/neuraltubedefects.html> updated 7 January 2013, accessed 16 January 2013

[10] “Spina Bifida: MedlinePlus”  , U.S. National Library of Medicine, National Institutes of Health. available at <http://www.nlm.nih.gov/medlineplus/spinabifida.html> updated 7 January 2013, accessed 16 January 2013.

[11] Ibid.

[12] Ibid.