Lund, Sweden—Maternal use of antidepressants during pregnancy was associated with increased neonatal morbidity and a higher rate of admissions to the neonatal intensive care unit (NICU), according to a large Swedish study.
The absolute risk for severe disease was low, however, according to the article in the journal Pediatrics, which was the latest to raise concerns about depression-medication usage in pregnant women.
The study, led by researchers from the Centre of Reproduction Epidemiology of Tornblad Institute at Lund University, sought to estimate the rate of admissions to NICUs, as well as infants’ morbidity and neonatal interventions, after exposure to selective serotonin reuptake inhibitor (SSRI) drugs in utero.
To do that, the study team obtained data on pregnancies, deliveries, prescription drug use, and health status of the newborn infants from the Swedish Medical Birth Register, the Prescribed Drug Register, and the Swedish Neonatal Quality Register. Included were 741,040 single infants born between July 1, 2006, and Dec.31, 2012.
Of the newborns, 2.4% had mothers who used SSRIs during pregnancy. Those infants exposed to an SSRI were compared with non-exposed infants, and infants exposed during late pregnancy were compared with those exposed during early pregnancy only.
Results indicate that, after maternal use of an SSRI, 13.7% of the infants were admitted to the NICU compared with 8.2% in the population, for an adjusted odds ratio of 1.5.
The admission rate to the NICU after treatment during late pregnancy, meanwhile, was 16.5% compared with 10.8% after treatment during early pregnancy only, for an adjusted odds ratio of 1.6.
Respiratory and central nervous system disorders and hypoglycemia were more common after maternal use of an SSRI, study authors report. That was especially the case with infants exposed to SSRIs in late pregnancy compared with early pregnancy; they had a higher risk of persistent pulmonary hypertension, with a number needed to harm of 285.
A recent study in JAMA Psychiatry also found that, when expectant mothers had depression-related psychiatric disorders and, especially when they purchased SSRIs at least twice during their pregnancies, their offspring had an increased risk for speech/language disorders.
Background information in that article notes that the use of SSRIs, which can cross the placenta and enter the fetal circulation, is increasing.
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