1. Fluoxetine and congenital malformations: a systematic review and meta-analysis of cohort studies.
- Author
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Gao SY, Wu QJ, Zhang TN, Shen ZQ, Liu CX, Xu X, Ji C, and Zhao YH
- Subjects
- Abnormalities, Drug-Induced etiology, Female, Heart Septal Defects chemically induced, Humans, Incidence, Infant, Pregnancy, Pregnancy Trimester, First, Publication Bias, Abnormalities, Drug-Induced epidemiology, Antidepressive Agents, Second-Generation adverse effects, Depression drug therapy, Fluoxetine adverse effects, Heart Septal Defects epidemiology, Pregnancy Complications drug therapy
- Abstract
Aims: To investigate the safety of fluoxetine use during pregnancy, and to better understand the relationship between maternal fluoxetine use during the first trimester and congenital malformations in infants., Methods: PubMed and Web of Science databases were systematically searched from inception to 21 March 2016. Additional studies were identified in a manual search of the reference lists. Two reviewers independently extracted data. A third reviewer checked the data. Estimates were pooled using a random-effects model to calculate the summarized relative ratios (RR) and 95% confidence intervals (CI)., Results: Among 1918 initially identified articles, 16 cohort studies were included. The offspring of pregnant women exposed to fluoxetine during the first trimester had a statistically increased risk of major malformations (RR = 1.18, 95% CI = 1.08-1.29), cardiovascular malformations (RR = 1.36, 95% CI = 1.17-1.59), septal defects (RR = 1.38, 95% CI = 1.19-1.61), and non-septal defects (RR = 1.39, 95% CI = 1.12-1.73) with low heterogeneity in infants. There were no significant observations of other system-specific malformations in the nervous system, eye, urogenital system, digestive system, respiratory system, or musculoskeletal system, respectively. There was no indication of publication bias., Conclusions: The results of this meta-analysis indicate maternal fluoxetine use is associated with a slightly increased risk of cardiovascular malformations in infants. Health care providers and pregnant women must weigh the risk-benefit potential of these drugs when making decisions about whether to treat with fluoxetine during pregnancy., (© 2017 The British Pharmacological Society.)
- Published
- 2017
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