A pregnant woman taking anti-depressant SSRI (selective serotonin reuptake inhibitor) drugs does not have an increased risk of stillbirth or infant mortality.
The finding was published in JAMA and came from new research involving almost 30,000 females from Denmark, Finland, Iceland, Norway and Sweden who were taking SSRI drugs during pregnancy.
The researchers found no notable link between SSRI drug use and risk of neonatal death, postneonatal death, or stillbirth, even after controlling for variables such as maternal psychiatric disease.
On the other hand, prior research demonstrated that kids have a higher chance of being born with high blood pressure in the lungs if the mother was taking anti-depressants during pregnancy, and a different study, published in The Lancet, indicated that children whose moms were taking SSRI drugs during pregnancy may be born with withdrawal syndrome.
Backround information in the report stated:
“Depression during pregnancy is common with prevalences ranging between 7 percent and 19 percent in economically developed countries. Maternal depression is associated with poorer pregnancy outcomes, including increased risk of preterm delivery, which in turn may cause neonatal morbidity and mortality.
Use of selective serotonin reuptake inhibitors during pregnancy has been associated with congenital anomalies, neonatal withdrawal syndrome, and persistent pulmonary hypertension of the newborn. However, the risk of stillbirth and infant mortality when accounting for previous maternal psychiatric disease remains unknown.”
The team of experts, led by Olof Stephansson, M.D., Ph.D., of the Karolinska Institutet, Stockholm, Sweden, set out to analyze whether a pregnant woman taking SSRI drugs has a higher chance of neonatal death, stillbirth, and postneonatal death.
The women observed in the study had single births between 1996 and 2007. The information on their SSRI drug use was gathered from prescription registries. Patient and medical birth registries were used to obtain information on pregnancy, maternal characteristics, and neonatal outcomes.
The relative risks of neonatal death, postneonatal death, and stillbirth linked to SSRI exposure during pregnancy were approximated by the scientists, while adjusting for variables including prior psychiatric hospitalization and maternal characteristics.
Results showed that out of the 1,633,877 births examined, there were 3,609 neonatal deaths, 1,578 postnatal deaths, and 6,054 stillbirths. There were 1.79% (29,228) of women who were taking SSRI drugs during pregnancy.
The team discovered that mothers who took an SSRI had higher rates of stillbirth (4.62 vs. 3.69 per 1000) and postneonatal death (1.38 vs. 0.96 per 1000) compared to subjects who were not exposed.
The SSRI group and the group who was not exposed to the drugs had similar rates of neonatal death (2.54 vs. 2.21 per 1000). “Yet in multivariate models, SSRI use was not associated with stillbirth, neonatal death, or postneonatal death. Estimates were further attenuated when stratified by previous hospitalization for psychiatric disease,” the researchers said.
The authors concluded:
“The present study of more than 1.6 million births suggests that SSRI use during pregnancy was not associated with increased risks of stillbirth, neonatal death, or postneonatal death. 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.
However, decisions regarding use of SSRIs during pregnancy must take into account other perinatal outcomes and the risks associated with maternal mental illness.”
Written by Sarah Glynn