For example, a study published in 2007 in The New England Journal of Medicine concluded that "Maternal use of SSRIs during early pregnancy was not associated with significantly increased risks of congenital heart defects or of most other categories of birth defects." The same study, however, noted that maternal use of SSRIs was associated with anencephaly, craniosynostosis and omphalocele.
Researchers noted that the risk of developing those birth defects after using SSRI medications overall was small but did find that the use of paroxetine (Paxil) or citalopram (Celexa) "significantly increased" the risk of anencephaly, craniosynostosis and omphalocele.
Anencephaly is a serious condition in which the upper part of the infant's neural tube fails to close properly. Infants born with anencephaly are born without the front part of the brain and without the cerebrum. Brain tissue that has developed is often—although not always—exposed. There is no current treatment or cure for anencephaly and the prognosis is poor. Those born with a less severe form of anencephaly can live for years but those born with a severe form might only live hours or days.
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Omphalocele occurs when the infant's intestines or liver stick out of the belly through the bellybutton. If all of the abdominal organs are outside the baby's body, the baby may have further complications because the abdominal cavity may not grow to its normal size. Treatment can involve one or more surgeries to move the organs inside the body.
Celexa is listed in the FDA's pregnancy category C, meaning that studies on animals indicate there could be a risk of birth defects, but the same results have not been adequately shown in human studies. This has left it up to individual women and their doctors to determine if the benefits of taking Celexa during pregnancy outweigh the risks.