Cleft palate – a craniofacial defect characterized by an opening in the roof of the mouth which can range from a small notch to a split that runs along the entire length of the palate. Children with cleft palates may appear deformed, have problems with feeding and speech and may be at risk of developing ear infections. Treatment for cleft palate usually involves surgery within the first year of life.
Gastroschisis – a birth defect in which the baby’s intestines stick out of the body through a hole in the abdominal wall. An infant both with gastroschisis will have unprotected intestines exposed to amniotic fluid in the womb. Babies born with this birth defect will need surgery, and prognosis depends on the size of the abdominal cavity and severity of the birth defect.
In this study exposure to venlafaxine was defined to be any reported use of the drug from one month preconception through the third month of pregnancy. To assess only the effects of venlafaxine, women who reported using other antidepressants were excluded from the study. To control for the possibility that some mothers who reported no exposure had in fact taken the drug, the authors reassessed their data assuming that the actual number of control mothers who had taken venlafaxine was 30% higher than the number who reported exposure. Their reassessment nevertheless found “all associations remained elevated.”
Discussing the implications of their results, the researchers noted that the two neurotransmitters most affected by venlafaxine, serotonin and norepinephrine, have been shown to play an important role in the development of the embryo into a fetus. They wrote, “Thus, if venlafaxine is taken during early pregnancy and interferes with these embryologic signaling pathways, it is plausible that venlafaxine could affect craniofacial and cardiac development. This is consistent with our findings of associations with septal heart defects, LVOTO defects [left ventricular outflow tract obstruction. Coarctation of the aorta is one example of this defect.], and cleft palate.”
The authors concluded, “Our data suggest associations between periconceptional [occurring around the time of conception] use of venlafaxine and some birth defects” and called for additional studies to confirm their results.
Polen KN, Rasmussen SA, Riehle-Colarusso T, Reefhuis J and the National Birth Defects Prevention (2012). Association between Reported Venlafaxine Use in Early Pregnancy and Birth Defects, National Birth Defects Prevention Study, 1997-2007. Birth Defects Research, Part A: Clinical and Molecular Teratology. doi:10.1002/bdra.23096.