New Study Reveals Benefits, Risks of Antidepressants During Pregnancy

NEW YORK -- August 4, 2015 -- Treating maternal psychiatric disorder with selective serotonin reuptake inhibitors (SSRIs) is associated with a lower risk of certain pregnancy complications including preterm birth and delivery by Caesarean section; however, SSRIs resulted in an increased risk of neonatal problems, according to a study published online in the American Journal of Psychiatry.

“To our knowledge, the association between taking antidepressants in pregnancy and a lower risk of preterm birth is a novel finding,” said senior author Alan Brown, MD, Columbia University’s Mailman School of Public Health, New York, New York. “Up to now, studies which were based on maternal underlying psychiatric illness had small sample sizes and reported inconsistent results.”

The researchers studied 845,345 single births from 1996 to 2010 from the Finnish Medical Birth Register. They also analysed data from national registers on prescription drug purchases, mothers' psychiatric history, maternal medical history, hospital sources, and healthcare professionals.

The women were categorised into mutually exclusive groups: SSRI users, those with a psychiatric diagnosis related to SSRI use but no antidepressant purchases, and those without a diagnosis or antidepressant purchases, to determine if outcomes were a result of maternal underlying psychiatric illness or due to use of the drugs.

This class of antidepressants is the most commonly used for treating depression and anxiety during pregnancy, with 4% to 10% of pregnant women prescribed them in Finland and in the United States. A total of 12,817 women in the study had purchased the antidepressants during the first trimester or 30 days before the beginning of gestation, and 9,322 (59%) made 2 or more purchases.

The risk of preterm birth was 16% lower, and the risk of very preterm birth nearly 50% lower in women using the antidepressants during pregnancy compared with mothers with a psychiatric diagnosis but no medication use.

Maternal psychiatric disorder without medication use was associated with an increased risk of Caesarean section (26.5%) compared with those without a diagnosis or antidepressant purchases (17%). There was a slightly greater risk of bleeding during or after delivery (3.5%) for women with a diagnosis but in the no-medication group as compared with those without a diagnosis or anti-depressant purchases (3%).

While the risk of being born small for gestational age did not differ for the babies of mothers with or without antidepressant drug treatment, SSRI use was associated with an increased risk of all neonatal problems, including breathing issues, that led to longer hospital stays and neonatal care.

“Our findings provide evidence that taking these antidepressants is associated with a lower risk of preterm birth and Caesarean section and further confirm the results from previous research of a higher risk for several neonatal problems,” said Dr. Brown. “Given these divergent findings, the decision whether to prescribe these medications during pregnancy should be individualised to the mother’s medical and psychiatric history.”

SOURCE: Columbia University’s Mailman School of Public Health
Log in to post comments

Tell us what you think of DG News

Click to like Click to dislike