Background Recent studies have reported conflicting results on the association between selective serotonin reuptake inhibitors ( SSRI s) and the risk of heart defects. We aimed to assess the association between SSRI s in pregnant women during the first trimester and the risk of congenital heart defects. Methods and Results PubMed and EMBASE up to July 2014 were searched for population‐based cohort studies that reported SSRI s in pregnant women during the first trimester and live infants’ heart defects at follow‐up. A meta‐analysis of published data was undertaken primarily by means of fixed‐effects models. Four cohort studies including 1 996 519 participants were included with a mean follow‐up period ranging from discharge to 72 months. SSRI s were not associated with increased risks of heart defects 1.06 (95% confidence interval: 0.94 to 1.18). Conclusions SSRI s during the first trimester in pregnant women were not associated with increased risks for newborn heart defects.