Women who take an antidepressant in the early stages of pregnancy increase the risk of their babies having facial malformations, including cleft lip and cleft palate.
Cleft LipA cleft is the gap left when parts of a fetus do not fully form and fuse together. A cleft lip (cheiloschisis) occurs on the upper lip and can vary in size, even extending all the way to the nose. The cleft can be a single groove or even be bilateral gaps on each side of the lip. This type of deformity can cause delays in speech and language as well as problems with socialization that are inherent with any major physical deformity.
Cleft PalateA cleft palate (palatoschisis) is the split that forms when the roof of a baby's mouth does not grow together. It can be as small as a hole on the roof of the mouth (the palate) or as large as the entire palate and jaw. Cleft palate can interfere with feeding, speech and breathing. Ear infections and hearing loss also are possible with this deformity.
Diagnosis and TreatmentRoutine ultrasounds performed during pregnancy sometimes can reveal the orofacial clefts. It is more common, however, for the deformities to be discovered only after birth, necessitating treatment. If a baby is born with cleft lip, cleft palate or the combination of both, the infant's parents can expect a schedule of multiple surgeries, often beginning before the child is three months old. Because a complete cleft palate affects the child's teeth and jaw, a bone graft is needed to close the split and extensive orthodontic and dental care is necessary after the surgeries. Cleft lip and cleft palate both affect a child's appearance significantly prior to surgery. Even after surgery, speech and hearing problems are common, although they can be overcome with physical therapy and sometimes with additional surgeries. Psychological issues are also a concern during the rehabilitation phase and should not be overlooked.
Antidepressants and Other Side EffectsDefective cleft palates and cleft lips are among many birth defects linked by research to the use of antidepressants during pregnancy. Others include serious heart and lung defects, respiratory distress, anencephaly and neural tube defects.
Because of the numerous risks, the FDA listed Celexa, Effexor, Lexapro, Paxil, Prozac, Wellbutrin and Zoloft in January 2012 among its Top 10 medications that should be avoided by pregnant women. The agency came to that conclusion after multiple tests, experiments and surveys.