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Antidepressants during pregnancy linked to adverse birth outcomes

Prenatal antidepressant use was significantly associated with adverse birth outcomes such as preterm delivery and low birth weight, although differences between mothers exposed to antidepressants and those who were not exposed were small, according to study findings.

“Treatment decisions must weigh the effect of untreated maternal depression against the potential adverse effects of antidepressant exposure,” the researchers wrote.

Untreated depression has been linked to increased morbidity and mortality in mothers and their children.To resolve conflicting data regardingthe potential risks of prenatal antidepressant treatment, Lori E. Ross, PhD, of the Centre for Addiction and Mental Health in Toronto, and colleagues performed a meta-analysis of several study databases to examine the relationship between maternal antidepressant exposure and adverse birth outcomes.

Results indicated that spontaneous abortion was not significantly associated with antidepressant exposure (OR=1.47; 95% CI, 0.99-2.17), but gestational age (mean difference in weeks, –0.45; 95% CI, –0.64 to –0.25) and preterm delivery (OR=1.55; 95% CI, 1.38-1.74) were significantly associated with antidepressant exposure.

Prenatal antidepressant use also was significantly associated with lower birth weight (mean difference in grams, –74; 95% CI, –117 to –31). However, limiting the comparison to only depressed mothers who were not exposed to the medication, the association was no longer significant. Antidepressant use also was significantly associated with lower Apgar scores at 1 (standardized mean difference, –0.19; 95% CI, –0.30 to –0.08) and 5 (–0.33; 95% CI, –0.47 to –0.20) minutes.

To gain a clearer picture of the potential risks associated with prenatal antidepressant exposure vs. untreated depression, the researchers wrote that future studies should control for maternal depression to separate the observed effects of antidepressant exposure from those of the disorder, and that maternal smoking also should be included in any future analyses.

Disclosure: See the study for a full list of financial disclosures.