Evidence map›Paper›PMID 39266712›Full record

SynthesisMolecular psychiatry2025

Safety of psychotropic medications in pregnancy: an umbrella review.

Nicholas Fabiano, Stanley Wong, Arnav Gupta, Jason Tran, Nishaant Bhambra, Kevin K Min, Elena Dragioti, Corrado Barbui, Jess G Fiedorowicz, Corentin J Gosling and 8 more

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Molecular psychiatry, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Guideline
  2. Article
  3. Article
  4. Article
  5. Article
  6. Review
  7. Article
  8. Review
  9. Article
  10. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Nicholas FabianoSCIENCES Lab, Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada.ORCID 0000-0002-6873-5105
Stanley WongSCIENCES Lab, Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada.
Arnav GuptaDepartment of Medicine, University of Calgary, Calgary, AB, Canada.
Jason TranDepartment of Psychiatry, University of Toronto, Toronto, ON, Canada.
Nishaant BhambraDepartment of Family Medicine, University of Ottawa, Ottawa, ON, Canada.
Kevin K MinFaculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
Elena DragiotiResearch Laboratory Psychology of Patients, Families & Health Professionals, Department of Nursing, School of Health Sciences, University of Ioannina, Ioannina, Greece.
Corrado BarbuiWHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy.ORCID 0000-0003-1073-9282
Jess G FiedorowiczDepartment of Psychiatry, University of Ottawa, Ottawa, ON, Canada.ORCID 0000-0003-2057-4071
Corentin J GoslingDysCo Laboratory, Université Paris Nanterre, F9200, Nanterre, France.
Samuele CorteseCentre for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK.ORCID 0000-0001-5877-8075
Jasmine GandhiDepartment of Psychiatry, University of Ottawa, Ottawa, ON, Canada.
Gayatri SarafDepartment of Psychiatry, University of Ottawa, Ottawa, ON, Canada.
Risa ShorrLibrary Services, The Ottawa Hospital, Ottawa, ON, Canada.
Simone N VigodDepartment of Psychiatry, Women's, College Hospital and University of Toronto, Toronto, ON, Canada.
Benicio N FreyDepartment of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.ORCID 0000-0001-8267-943X
Richard DelormeChild and Adolescent Psychiatry Department, Robert Debré Hospital, APHP, University of Paris Cité, Paris, France.
Marco SolmiSCIENCES Lab, Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada. msolmi@toh.ca.ORCID 0000-0003-4877-7233

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Weighing risks and benefits of the use of psychotropic medications during pregnancy remains a challenge worldwide. We systematically assessed the strength of associations between psychotropic medication use in pregnant people with mental disorders and various adverse health outcomes in both pregnant people and foetuses. Systematic reviews with meta-analyses of observational studies investigating the association between exposure to psychotropic medication in pregnancy and any adverse health outcomes were included. Credibility was graded into convincing, highly suggestive, suggestive, weak or not significant. Quality of the meta-analyses and of individual studies were assessed with A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2) the Newcastle-Ottawa Scale (NOS), respectively. We considered 21 meta-analyses encompassing 17,290,755 participants (AMSTAR 2 high = 1, low = 12, or critically low = 8). Evidence was suggestive for: (1) preterm birth in pregnant people with either any mental disorder (equivalent odds ratio 1.62 (95% confidence interval 1.24-2.12) or depression (1.65 [1.34-2.02]) receiving antidepressants during any trimester of pregnancy; (2) small for gestational age for pregnant people with depression receiving a SSRI during any trimester of pregnancy (1.50 [1.19-1.90]); and (3) major congenital malformation (1.24 [1.09-1.40]) or cardiac malformations (1.28 [1.11-1.47]) in babies for pregnant people with depression or anxiety receiving paroxetine during first trimester of pregnancy. Additional associations were supported by weak evidence, or were not statistically significant. This umbrella review found no convincing or highly suggestive level of evidence of adverse health outcomes associated with psychotropic medication use in pregnant people with mental disorders.

Indexed as

Mental DisordersPregnancy ComplicationsPsychotropic DrugsAntidepressive AgentsDepressionFemaleHumansPregnancyPregnancy OutcomePremature BirthSelective Serotonin Reuptake InhibitorsAntidepressive AgentsPsychotropic DrugsSelective Serotonin Reuptake Inhibitors

Identifiers

PMID39266712
PMCPMC11649568

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.