title: Association of citalopram with congenital anomalies: A meta-analysis.
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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Education and Human Resources Department, Samsung Medical Center, Seoul, Korea.
authors.forename: Hyun-Hye
authors.initials: HH
authors.lastname: Kang
authors.affiliation: Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea.
authors.forename: Ki Hoon
authors.initials: KH
authors.lastname: Ahn
authors.affiliation: Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea.
authors.forename: Soon-Cheol
authors.identifier: 0000-0002-9330-7620
authors.initials: SC
authors.lastname: Hong
authors.affiliation: Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea.
authors.forename: Bo Yong
authors.initials: BY
authors.lastname: Kwon
authors.affiliation: Department of Pediatrics, Korea University College of Medicine, Seoul, Korea.
authors.forename: Eun Hee
authors.initials: EH
authors.lastname: Lee
authors.affiliation: Clinical Research Center, Asan Medical Center, Seoul, Korea.
authors.forename: Ji-Sung
authors.initials: JS
authors.lastname: Lee
authors.affiliation: Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea.
authors.forename: Min-Jeong
authors.initials: MJ
authors.lastname: Oh
authors.affiliation: Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea.
authors.forename: Hai-Joong
authors.initials: HJ
authors.lastname: Kim
keywords: Citalopram; Congenital anomalies; Heart defects; Meta-analysis; Pregnancy