Kolding L, Ehrenstein V, Pedersen L, et al. - In this nationwide registry-based study in Denmark, researchers explored the connection between first-trimester exposure to antidepressants and risk of cardiac malformations utilizing data on malformations among clinically recognized pregnancies from gestational week 11 onwards, regardless of fetal survival. From 2007 to 2014, 364,012 singleton pregnancies were analyzed. Using redeemed prescriptions, exposure to antidepressants was measured. Venlafaxine use during pregnancy is associated with an increased risk of severe cardiac malformations, but with low absolute risk. Direct effects or confounding by indication are examples of potential mechanisms. Venlafaxine exposure is a risk factor for high-risk pregnancies, which may necessitate fetal echocardiography.