{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T18:21:36Z","timestamp":1761675696481},"reference-count":25,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2009,8,18]],"date-time":"2009-08-18T00:00:00Z","timestamp":1250553600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Birth Defects Research"],"published-print":{"date-parts":[[2009,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:bold>BACKGROUND<\/jats:bold>: Selective serotonin reuptake inhibitors (SSRIs) have been suspected of cardiac teratogenicity, but reports have been inconsistent. Our aim was to investigate the rate of nonsyndromic congenital heart defects in newborns exposed in utero to SSRIs compared with unexposed controls. <jats:bold>METHODS<\/jats:bold>: This prospective study of women who gave birth at our tertiary center from 2000 to 2007 yielded 235 women who reported first\u2010trimester SSRI use during pregnancy. All newborns born during the study period and found to have a persistent cardiac murmur on day 2 or 3 of life were referred for examination by a pediatric cardiologist and by echocardiography. The findings were compared between the newborns who were exposed to SSRIs and those who were not. <jats:bold>RESULTS<\/jats:bold>: Nonsyndromic congenital heart defects were identified by echocardiography in 8 of 235 (3.40%) newborns exposed in utero to SSRIs and in 1083 of 67,636 (1.60%) non\u2010exposed newborns. The difference in prevalence between the two groups was significant (relative risk, 2.17; 95% confidence interval, 1.07\u20134.39). The prevalence rates for paroxetine and fluoxetine exposure were 4.3% and 3.0%, respectively. All cardiac defects in the study group were mild: ventricular septal defect (6), bicuspid aortic valve (1) and right superior vena cava to coronary sinus (1). <jats:bold>CONCLUSIONS<\/jats:bold>: Newborns exposed in utero to SSRIs, have a twofold higher risk of mild nonsyndromic heart defects than unexposed infants. The data suggest that women who require SSRI treatment during pregnancy can be reassured that the fetal risk is low and possible cardiac malformations will probably be mild. Late\u2010targeted ultrasound and fetal echocardiography at 22 to 23 weeks' gestation are recommended in this patient group. Birth Defects Research (Part A), 2009. \u00a9 2009 Wiley\u2010Liss, Inc.<\/jats:p>","DOI":"10.1002\/bdra.20615","type":"journal-article","created":{"date-parts":[[2009,8,18]],"date-time":"2009-08-18T18:25:45Z","timestamp":1250619945000},"page":"837-841","source":"Crossref","is-referenced-by-count":59,"title":["Are selective serotonin reuptake inhibitors cardiac teratogens? Echocardiographic screening of newborns with persistent heart murmur"],"prefix":"10.1002","volume":"85","author":[{"given":"Paul","family":"Merlob","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Einat","family":"Birk","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lea","family":"Sirota","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nehama","family":"Linder","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Berant","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bracha","family":"Stahl","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gil","family":"Klinger","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2009,8,18]]},"reference":[{"key":"e_1_2_5_2_1","first-page":"291","article-title":"Maternal use of selective serotonin reuptake inhibitors and risk for birth defects","volume":"73","author":"Alwan S","year":"2005","journal-title":"Birth Defects Res A Clin Mol Teratol"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa066584"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.1989.tb07167.x"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinthera.2007.05.003"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdrb.20099"},{"key":"e_1_2_5_7_1","first-page":"S6","article-title":"Paroxetine in the first trimester of pregnancy and the prevalence of congenital malformations [abstract]","volume":"15","author":"Cole JA","year":"2006","journal-title":"Pharmacoepidemiol Drug Safety"},{"key":"e_1_2_5_8_1","unstructured":"Diav\u2010CitrinO ShechtmanS WeinbaumD et al.2005.Pregnancy outcome after gestation exposure to paroxetine: a prospective controlled cohort study. Presented at the 45thAnnual Meeting of the Teratology Society St. Pete Beach Florida June 25\u201330 2005;"},{"key":"e_1_2_5_8_2","first-page":"459","volume":"20","year":"2005","journal-title":"Reprod Toxicol"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2125.2008.03261.x"},{"key":"e_1_2_5_10_1","first-page":"593","article-title":"Counseling pregnant women treated with paroxetine. Concern about cardiac malformations","volume":"52","author":"Einarson A","year":"2006","journal-title":"Can Fam Physician"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2007.07060879"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/070674370905400405"},{"key":"e_1_2_5_13_1","unstructured":"GlaxoSmithKline.2005.New safety information regarding paroxetine: findings suggest increased risk over other antidepressants of congenital malformations following first trimester exposure to paroxetine. 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