Zoloft May Result In Congenital Cardiac Malformations

As the most frequently used antidepressants among pregnant women, selective serotonin-reuptake inhibitors (SSRI’s) have developed a tarnished reputation. Amidst growing concerns over the safety of SSRI’s during pregnancy, researchers have discovered that SSRI’s may be responsible for a number of congenital cardiac malformations. Zoloft, in particular, has been the recipient of intense scrutiny after sertraline was associated with a threefold increased risk of cardiac malformations.

Sertraline, the active ingredient in Zoloft, resides in a category of medications known as selective serotonin-reuptake inhibitors. As an SSRI, it has the inherent ability to stabilize serotonin and other naturally occurring chemicals in the brain. After serotonin levels have been stabilized, the concentrated amounts of the chemical are able to stimulate the appropriate nerves in the brain. In doing so, depressive tendencies are significantly minimized in many patients.

Unfortunately, SSRI’s appear to readily come in contact with the placenta and significant questions have surfaced regarding their safety during pregnancy, including the risk of low birth weight, prematurity, low Apgar score, and persistent pulmonary hypertension in the newborn. Maternal SSRI use, particularly regarding Zoloft, during pregnancy has been associated with an almost twofold increased risk of congenital malformations. However, Zoloft may significantly increase the risk of a child developing severe cardiac malformations as well.

In an attempt to pinpoint the risks associated with specific antidepressants, researchers in Northern Denmark conducted a study involving 216,042 women who had a live birth after the 20th week of gestation. They then compared the prevalence of malformation in infants born to women who redeemed at least one SSRI prescription during early pregnancy with the prevalence in infants born to women who redeemed no SSRI prescriptions during their pregnancies.

In this population-based study, researchers discovered that overall maternal use of SSRIs in early pregnancy was associated with a 1.7-fold increased risk of congenital cardiac malformations. Septal heart defects were the most frequently recorded malformations among infants of exposed women, with sertraline (Zoloft) associated with a threefold increased risk of such defects.

They discovered a significantly elevated risk of septal defects related to Zoloft. In a US case-control study based on data from the Slone Epidemiology Center Birth Defects Study, researchers discovered a twofold increased risk of septal defects (95% CI: 1.2–4.0) associated with first-trimester use of Zoloft but not with other specific SSRI’s.

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