Table 4

Type of antidepressant use during pregnancy and the risk of major congenital malformations as well as organ-specific malformations in a cohort of depressed pregnant women

Crude prevalenceAdjusted* prevalence
Congenital malformationsOR (95% CI)OR (95% CI)
Major congenital malformations overall
 Non-exposed1.001.00
 Paroxetine1.39 (1.15 to 1.68)1.24 (0.99 to 1.55)
 Sertraline1.13 (0.83 to 1.55)1.09 (0.80 to 1.50)
 Citalopram[AQ3] 1.41 (1.11 to 1.78)1.36 (1.08 to 1.73)
 Fluoxetine0.83 (0.51 to 1.35)0.80 (0.49 to 1.31)
 Fluvoxamine0.63 (0.23 to 1.75)0.63 (0.23 to 1.77)
 Venlafaxine1.12 (0.89 to 1.41)1.10 (0.87 to 1.38)
 Tricyclic antidepressants1.23 (0.91 to 1.67)1.16 (0.86 to 1.56)
 Other antidepressants0.96 (0.61 to 1.52)0.93 (0.59 to 1.47)
Nervous system
 Non-exposed1.001.00
 Paroxetine1.37 (0.75 to 2.49)1.34 (0.74 to 2.42)
 Sertraline1.79 (0.73 to 4.38)1.72 (0.69 to 4.26)
 Citalopram1.32 (0.57 to 3.02)1.28 (0.55 to 2.93)
 Fluoxetine0.68 (0.10 to 4.80)0.64 (0.09 to 4.52)
 Fluvoxamine2.39 (0.33 to 17.05)2.44 (0.33 to 18.11)
 Venlafaxine1.20 (0.55 to 2.59)1.19 (0.55 to 2.58)
 Tricyclic antidepressants0.68 (0.17 to 2.72)0.60 (0.15 to 2.38)
 Other antidepressants1.34 (0.33 to 5.40)1.21 (0.30 to 4.89)
Eye, ear, face and neck
 Non-exposed1.001.00
 Paroxetine0.76 (0.31 to 1.88)0.75 (0.30 to 1.86)
 Sertraline0.47 (0.07 to 3.40)0.44 (0.06 to 3.18)
 Citalopram1.18 (0.43 to 3.23)1.13 (0.41 to 3.09)
 Fluoxetine0.91 (0.13 to 6.47)0.85 (0.12 to 5.94)
 Venlafaxine0.70 (0.22 to 2.22)0.70 (0.22 to 2.19)
 Tricyclic antidepressants2.74 (1.19 to 6.30)2.45 (1.05 to 5.72)
 Other antidepressants1.80 (0.44 to 7.36)1.71 (0.41 to 7.15)
Circulatory system
 Non-exposed1.001.00
 Paroxetine1.17 (0.83 to 1.65)1.13 (0.79 to 1.60)
 Sertraline1.31 (0.75 to 2.30)1.25 (0.71 to 2.19)
 Citalopram1.31 (0.84 to 2.06)1.27 (0.81 to 1.99)
 Fluoxetine0.56 (0.18 to 1.76)0.52 (0.16 to 1.65)
 Fluvoxamine2.06 (0.64 to 6.61)2.00 (0.62 to 6.47)
 Venlafaxine0.78 (0.47 to 1.30)0.77 (0.46 to 1.27)
 Tricyclic antidepressants1.04 (0.56 to 1.91)0.96 (0.52 to 1.77)
 Other antidepressants0.94 (0.38 to 2.31)0.88 (0.36 to 2.13)
Respiratory system
 Non-exposed1.001.00
 Paroxetine0.98 (0.43 to 2.23)0.95 (0.41 to 2.21)
 Fluoxetine1.93 (0.47 to 7.90)1.93 (0.47 to 7.85)
 Venlafaxine2.25 (1.13 to 4.50)2.17 (1.07 to 4.38)
 Tricyclic antidepressants0.96 (0.24 to 3.91)0.90 (0.22 to 3.61)
 Other antidepressants1.91 (0.47 to 7.82)1.79 (0.44 to 7.32)
Digestive system
 Non-exposed1.001.00
 Paroxetine0.97 (0.55 to 1.71)0.96 (0.54 to 1.71)
 Sertraline1.15 (0.47 to 2.83)1.13 (0.46 to 2.77)
 Citalopram1.16 (0.57 to 2.37)1.13 (0.55 to 2.32)
 Fluoxetine0.88 (0.22 to 3.58)0.87 (0.21 to 3.56)
 Venlafaxine0.91 (0.45 to 1.85)0.89 (0.44 to 1.83)
 Tricyclic antidepressants2.70 (1.49 to 4.89)2.55 (1.40 to 4.66)
 Other antidepressants0.44 (0.06 to 3.10)0.42 (0.06 to 2.98)
Genital organs
 Non-exposed1.001.00
 Paroxetine0.80 (0.42 to 1.53)0.79 (0.41 to 1.52)
 Sertraline0.97 (0.35 to 2.72)0.90 (0.31 to 2.61)
 Citalopram0.93 (0.41 to 2.13)0.86 (0.37 to 1.99)
 Fluoxetine0.50 (0.07 to 3.45)0.50 (0.07 to 3.35)
 Venlafaxine0.74 (0.30 to 1.81)0.69 (0.29 to 1.67)
 Tricyclic antidepressants1.24 (0.51 to 3.01)1.12 (0.46 to 2.72)
 Other antidepressants0.91 (0.23 to 3.58)0.83 (0.21 to 3.27)
Urinary system
 Non-exposed1.001.00
 Paroxetine0.46 (0.19 to 1.13)0.47 (0.19 to 1.14)
 Sertraline0.86 (0.27 to 2.73)0.86 (0.27 to 2.71)
 Citalopram0.18 (0.03 to 1.28)0.18 (0.02 to 1.26)
 Fluoxetine0.55 (0.08 to 3.94)0.56 (0.08 to 4.00)
 Venlafaxine1.43 (0.75 to 2.73)1.43 (0.75 to 2.73)
 Tricyclic antidepressants0.83 (0.26 to 2.60)0.80 (0.25 to 2.57)
 Other antidepressants0.54 (0.08 to 3.91)0.54 (0.08 to 3.86)
Musculoskeletal system
 Non-exposed1.001.00
 Paroxetine1.02 (0.75 to 1.37)1.01 (0.75 to 1.37)
 Sertraline1.06 (0.64 to 1.76)1.03 (0.62 to 1.71)
 Citalopram1.96 (1.44 to 2.68)1.92 (1.40 to 2.62)
 Fluoxetine1.00 (0.49 to 2.04)0.99 (0.48 to 2.01)
 Fluvoxamine0.88 (0.21 to 3.58)0.87 (0.21 to 3.57)
 Venlafaxine1.32 (0.95 to 1.84)1.30 (0.93 to 1.80)
 Tricyclic antidepressants0.88 (0.51 to 1.51)0.84 (0.49 to 1.44)
 Other antidepressants0.85 (0.40 to 1.83)0.83 (0.39 to 1.80)
Cardiac malformations
 Non-exposed1.001.00
 Paroxetine1.49 (1.11 to 2.00)1.45 (1.12 to 1.88)
 Sertraline1.19 (0.63 to 2.25)1.14 (0.60 to 2.15)
 Citalopram1.18 (0.71 to 1.97)1.15 (0.69 to 1.92)
 Fluoxetine0.45 (0.11 to 1.82)0.42 (0.10 to 1.73)
 Fluvoxamine2.45 (0.76 to 7.87)2.44 (0.75 to 7.95)
 Venlafaxine0.81 (0.47 to 1.40)0.80 (0.47 to 1.38)
 Tricyclic antidepressants1.12 (0.59 to 2.13)1.05 (0.55 to 1.99)
 Other antidepressants0.89 (0.33 to 2.42)0.84 (0.31 to 2.27)
Ventricular/atrial septal defect
 Non-exposed1.001.00
 Paroxetine1.43 (1.17 to 1.75)1.39 (1.00 to 1.93)
 Sertraline1.36 (0.69 to 2.65)1.33 (0.68 to 2.60)
 Citalopram1.41 (0.83 to 2.39)1.39 (0.82 to 2.36)
 Fluoxetine0.57 (0.14 to 2.30)0.55 (0.14 to 2.27)
 Fluvoxamine2.03 (0.49 to 8.36)2.10 (0.51 to 8.71)
 Venlafaxine0.74 (0.39 to 1.39)0.73 (0.39 to 1.39)
 Tricyclic antidepressants1.14 (0.56 to 2.32)1.10 (0.54 to 2.24)
 Other antidepressants1.14 (0.42 to 3.08)1.11 (0.41 to 2.97)
Craniosynostosis
 Non-exposed1.001.00
 Paroxetine1.44 (0.69 to 2.99)1.53 (0.72 to 3.25)
 Sertraline2.24 (0.82 to 6.16)2.29 (0.83 to 6.36)
 Citalopram3.89 (2.06 to 7.35)3.95 (2.08 to 7.52)
 Fluoxetine1.07 (0.15 to 7.65)1.14 (0.16 to 8.21)
 Venlafaxine1.38 (0.56 to 3.43)1.41 (0.57 to 3.52)
 Tricyclic antidepressants1.06 (0.26 to 4.36)1.05 (0.25 to 4.37)
 Other antidepressants1.05 (0.15 to 7.63)1.15 (0.16 to 8.42)
  • Ventricular/atrial septal defects are a subset of cardiac malformations. Results are provided when defects were identified for the antidepressant type in the study population (if 0 outcome identified).

  • *Adjusted for maternal age, welfare status, diabetes, hypertension, asthma and other medication uses including benzodiazepines as well as healthcare usage in the year prior and during the first trimester. Significant prevalence OR were bolded.