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Antidepressant use not associated with stillbirth, infant mortality
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Researchers have found no significant association between selective serotonin reuptake inhibitor use during pregnancy and increased risk for stillbirth, neonatal death or postneonatal death. Still, the researchers urged clinicians to remain cautious when prescribing the medication.
“[Selective serotonin reuptake inhibitor] use during pregnancy is relatively safe, but patients should discuss it with their doctors and use the lowest dose possible,” study researcher Olof Stephansson, MD, PhD, of the Karolinska Institutet in Stockholm, told Psychiatric Annals.
Olof Stephansson
Stephansson and colleagues examined the link between selective serotonin reuptake inhibitor (SSRI) use and adverse birth outcomes in 29,228 mothers from all Nordic countries who had filled a prescription for an SSRI during pregnancy. The study included 1,633,877 singleton births, 6,054 of which were stillbirths, 3,609 neonatal deaths and 1,578 postneonatal deaths.
Logistic regression analyses were used to estimate the risks for adverse birth outcomes.
Women exposed to an SSRI during pregnancy presented with higher rates of stillbirth (4.62 vs. 3.69 per 1,000; P=.01) and postneonatal death (1.38 vs. 0.96 per 1,000; P=.24) compared with women who were not exposed. The rate of neonatal mortality was similar between both groups (2.54 vs. 2.21 per 1,000; P=.24). However, adjusting for maternal characteristics, country and year of birth, the researchers found that SSRI use was not associated with stillbirth (adjusted OR=1.17; 95% CI, 0.96-1.41), neonatal death (aOR=1.23; 95% CI, 0.96-1.57) or postneonatal death (aOR=1.34; 95% CI, 0.97-1.86).
“The increased rates of stillbirth and postneonatal mortality among infants exposed to an SSRI during pregnancy were explained by the severity of the underlying maternal psychiatric disease and unfavorable distribution of maternal characteristics such as cigarette smoking and advanced maternal age,” the researchers wrote.
Disclosure: The researchers report no relevant financial disclosures.