The link between birth defects and SSRI (selective serotonin reuptake inhibitor) use has been established since the early 2000s, though researchers are still discovering the extent of the risk. Selective serotonin reuptake inhibitors work by blocking the uptake of serotonin released by the body. Serotonin is one of the body’s most-important neurotransmitters and regulates a number of biological processes. When this balance is interrupted in pregnant women, it can have profound effects on the unborn child, many of which will permanently reduce the child’s quality of life.

WHAT DOES THE RESEARCH SAY ABOUT BIRTH DEFECTS AND SSRI USE?

In a 2005 Danish study, researchers found that women who took these medications during the first trimester of pregnancy were putting their children at major risk. The study’s results discovered a 60 percent increased risk of heart problems in children who had been exposed to an SSRI during the first trimester. Other studies, including one published in the New England Journal of Medication, determined there was also an increased risk of birth complications when using these medications during the final trimester. Another study, published in 2006 in a French medical journal, concluded that between 20 and 30 percent of children developed severe complications after being exposed to these medications during pregnancy.

As a result of these concerns, the Food and Drug Administration has placed most drugs in this class in Pregnancy Category C
. Category C is reserved for medications that have produced adverse effects in animal fetuses. In general, there is no ethical way to test human fetuses in this way, so researchers can only study children who have already been harmed by the drug.

Paxil is the only drug in this class that has been placed in Pregnancy Category D. Medications in category D have conclusively demonstrated adverse effects in human fetuses. As Paxil is chemically similar to other drugs in its class, it is likely that the link between birth defects and SSRI use will only become stronger in time.

WHAT ARE THE MOST-COMMON HEALTH COMPLICATIONS ASSOCIATED WITH THESE DRUGS?

This class of drugs is responsible for a number of severe, long-term conditions that often result in early death of a child or major impairment. Some of the most-common complications include:

Persistent Pulmonary Hypertension of the Newborn (PPHN)

PPHN is a severe problem in the child’s lungs and heart. In effect, the child cannot breathe outside the womb and must be supported during treatment. PPHN can result in brain or major organ damage.

Ventricle problems

These drugs usually affect the heart the most and can cause significant deformities in its structure. This includes Tetralogy of Fallot, inadequate division of heart chambers and aorta problems.

Neural tube complications

These medications can also result in severe issues in brain and organ development, including increased risks of omphalocele, anencephaly and craniosynostosis. Anencephaly and craniosynostosis are deformities in the brain and skull development. Anencephaly typically results in death soon after the child’s birth. Omphalocele is a treatment condition in which the child’s visceral organs have developed outside of the child’s body. Omphalocele has to be treated shortly after birth to preserve the child’s health.