1 January 2013
Study finds no link between antidepressants and stillbirth
European researchers have found no significant association between selective serotonin reuptake inhibitor (SSRI) antidepressant use during pregnancy and risk of stillbirth, neonatal death, or postneonatal death. The results of the study, that included nearly 30,000 women from Nordic countries, appear in the latest issue of the JAMA.
Depression during pregnancy is common, with prevalence ranging between 7 percent and 19 percent in developed countries. It has been associated with poorer pregnancy outcomes, including increased risk of preterm delivery, which in turn may cause neonatal morbidity and mortality.
The use of SSRI meds to treat depression during pregnancy has previously been associated with congenital anomalies, neonatal withdrawal syndrome, and persistent pulmonary hypertension of the newborn.
In the new study, Olof Stephansson, of the Karolinska Institutet, Stockholm, investigated whether SSRI exposure during pregnancy was associated with increased risks of stillbirth, neonatal death, and postneonatal death. This involved obtaining information on maternal use of SSRIs from prescription registries. Maternal characteristics, pregnancy, and neonatal outcomes were obtained from patient and medical birth registries. The researchers estimated relative risks of stillbirth, neonatal death, and postneonatal death associated with SSRI use during pregnancy taking into account maternal characteristics and previous psychiatric hospitalization.
The researchers found that SSRI use was not associated with stillbirth, neonatal death, or postneonatal death. They issued a cautionary note, however. "Decisions regarding use of SSRIs during pregnancy must take into account other perinatal outcomes and the risks associated with maternal mental illness," they warn.
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