 Antidepressant exposure (including paroxetine) is associated with shorter duration of pregnancy (by three days), increased risk of preterm delivery (by 55%), lower birth weight (by 75 g), and lower Apgar scores (by <0.4 points).The American College of Obstetricians and Gynecologists recommends that for pregnant women and women planning to become pregnant, "be avoided, if possible", as paroxetine may be associated with increased risk of birth defects.Babies born to women who used paroxetine during the first trimester paroxetine have an increased risk of cardiovascular malformations, primarily ventricular and atrial septal defects (VSDs and ASDs).