Obstet Gynecol Sci.  2017 Mar;60(2):145-153. 10.5468/ogs.2017.60.2.145.

Association of citalopram with congenital anomalies: A meta-analysis

• Kang HH
• Ahn KH
• Hong SC
• Kwon BY
• Lee EH
• Lee JS
• Oh MJ
• Kim HJ

• KMID: 2372798
• DOI: http://doi.org/10.5468/ogs.2017.60.2.145

Abstract

OBJECTIVE
The antenatal use of citalopram, a widely prescribed selective serotonin reuptake inhibitor, has been suspected to be associated with congenital, particularly cardiac, anomalies. This study aimed to prove the association between citalopram use and congenital anomalies.
METHODS
We searched the English literature from July 1998 to July 2015, by using the search terms "˜ citalopram', "˜ pregnancy', "˜ birth defects', "˜ congenital anomalies', and "˜ malformations' in PubMed, Embase, Web of Science, and the Cochrane Library.
RESULTS
Eight eligible articles were analyzed including a total of 1,507,896 participants. The odds ratio (OR) of major malformations associated with citalopram use during pregnancy was 1.07 (95% confidence interval [CI], 0.98 to 1.17). Concerning cardiac malformations, the OR for all included studies was 1.31 (95% CI, 0.88 to 1.93). The analysis of cardiac malformations was repeated to reduce heterogeneity after excluding one outlier study (OR, 1.03; 95% CI, 0.84 to 1.26).
CONCLUSION
From our data, it can be concluded that citalopram use is not associated with major birth defects. However, physicians should carefully weigh the benefits against the potential risks of citalopram use, and counsel patients accordingly.

Keyword

Citalopram; Congenital anomalies; Heart defects; Meta-analysis; Pregnancy

MeSH Terms

Citalopram*
Congenital Abnormalities
Humans
Odds Ratio
Parturition
Population Characteristics
Pregnancy
Serotonin
Citalopram
Serotonin

Figure

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  Fig. 1 Study selection process.

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  Fig. 2 Forest plot for major malformations (A) and cardiac malformations (B) (excluded: Oberlander et al., 2008 [5]). TE, estimated treatment effect; seTE, standard error of TE; OR, odds ratio; CI, confidence interval.

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