Study: Use of anti-depressants during pregnancy not linked with increased risk of stillbirth, infant death

January 1, 2013, JAMA and Archives Journals

In a study that included nearly 30,000 women from Nordic countries who had filled a selective serotonin reuptake inhibitor (SSRI) prescription during pregnancy, researchers found no significant association between use of these medications during pregnancy and risk of stillbirth, neonatal death, or postneonatal death, after accounting for factors including maternal psychiatric disease, according to a study in the January 2 issue of JAMA.

"Depression during pregnancy is common with prevalences ranging between 7 percent and 19 percent in economically developed countries. is associated with poorer , including increased risk of preterm delivery, which in turn may cause and mortality," according to background information in the article. "Use of during pregnancy has been associated with congenital anomalies, neonatal withdrawal syndrome, and persistent pulmonary hypertension of the newborn. However, the risk of stillbirth and when accounting for previous maternal psychiatric disease remains unknown."

Olof Stephansson, M.D., Ph.D., of the Karolinska Institutet, Stockholm, Sweden and colleagues conducted a study to examine whether SSRI exposure during pregnancy was associated with increased risks of stillbirth, neonatal death, and postneonatal death. The study included women with single births from all Nordic countries (Denmark, Finland, Iceland, Norway, and Sweden) at different periods from 1996 through 2007. The researchers obtained information on maternal use of SSRIs from prescription registries; maternal characteristics, pregnancy, and neonatal outcomes were obtained from patient and medical birth registries. The authors estimated relative risks of stillbirth, neonatal death, and postneonatal death associated with SSRI use during pregnancy taking into account maternal characteristics and previous .

Among 1,633,877 in the study, there were 6,054 stillbirths; 3,609 neonatal deaths; and 1,578 postneonatal deaths. A total of 29,228 (1.79 percent) of mothers had filled a prescription for an SSRI during pregnancy. The researchers found that women exposed to an SSRI had higher rates of stillbirth (4.62 vs. 3.69 per 1000) and postneonatal death (1.38 vs. 0.96 per 1000) than those who did not. The rate of neonatal death was similar between groups (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 authors write.

"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," the researchers conclude.

Explore further: Infant mortality linked to subsequent risk of stillbirth finds new US study

More information: JAMA. 2013;309(1):48-54

Related Stories

Infant mortality linked to subsequent risk of stillbirth finds new US study

September 21, 2011
Women whose first pregnancy ended in infant death are significantly more likely to have a subsequent stillbirth finds new research published today (21 September) in BJOG: An International Journal of Obstetrics and Gynaecology.

Women with polycystic ovary syndrome at increased risk of pregnancy complications

October 13, 2011
Women with polycystic ovary syndrome are more likely to have problems with pregnancy regardless of whether they are undergoing fertility treatment, claims new research published in the British Medical Journal today.

Not enough is known about prescription drug use in pregnancy, say experts

April 27, 2012
Prescription drug use during pregnancy is prevalent, however, not enough is known about the adverse effects they may have on the developing fetus, concludes a new review published in The Obstetrician & Gynaecologist (TOG) ...

Nordic study shows marginally higher but overall low risk of stillbirth in ART children

July 6, 2011
A research group from the Nordic countries (the MART group -- Morbidity in ART) found a marginally higher but overall still low risk of stillbirth among children conceived after assisted reproduction treatment (ART) compared ...

Exposure to certain antidepressants in pregnancy may modestly increase risk of autism spectrum disorders

July 4, 2011
Prenatal exposure to selective serotonin reuptake inhibitors, especially during the first trimester, is associated with a modest increase the risk of developing an autism spectrum disorder, according to a report published ...

Recommended for you

New report calls into question effectiveness of pregnancy anti-nausea drug

January 17, 2018
Previously unpublished information from the clinical trial that the U.S. Food and Drug Administration relied on to approve the most commonly prescribed medicine for nausea in pregnancy indicates the drug is not effective, ...

New study finds 'baby brain' is real, but the cause remains mysterious

January 15, 2018
So-called "baby brain" refers to increased forgetfulness, inattention, and mental "fogginess" reported by four out of five pregnant women. These changes in brain function during pregnancy have long been recognised in midwifery ...

Sleep quality improves with help of incontinence drug

January 12, 2018
A drug used to curtail episodes of urinary incontinence in women also improves quality of sleep, a researcher at the Stanford University School of Medicine reports.

Frozen embryos result in just as many live births in IVF

January 10, 2018
Freezing and subsequent transfer of embryos gives infertile couples just as much of a chance of having a child as using fresh embryos for in vitro fertilization (IVF), research from Ho Chi Minh City, Vietnam, and Adelaide, ...

Study suggests air pollution breathed in the months before and after conception increases chance of birth defects

January 8, 2018
A team of researchers with the University of Cincinnati and Cincinnati Children's Hospital has found evidence that indicates that pre-and post-pregnant women living in an area with air pollution are at an increased risk of ...

Taking paracetamol during pregnancy may reduce fertility of daughters

January 5, 2018
Taking paracetamol during pregnancy may impair the future fertility of female offspring, according to a review published in Endocrine Connections. The article reviews three separate rodent studies that all report altered ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.