Risks associated with selective serotonin reuptake inhibitors in pregnancy

Area of Science:

• Perinatal Medicine
• Pharmacology
• Reproductive Health

Background:

• Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed for depression.
• Understanding SSRI safety during pregnancy is crucial for clinical decision-making.

Purpose of the Study:

• To investigate the association between SSRI use during pregnancy and various adverse perinatal outcomes.
• To assess risks including major malformations, preterm birth, and neonatal care needs.

Main Methods:

• Population-based study using linked national health registers in Finland.
• Included 1782 women with SSRI purchases during pregnancy and matched controls.
• Analyzed singleton pregnancies for outcomes like major malformations, preterm birth, and neonatal intensive care.

Main Results:

• No increased risk of major malformations was observed with first-trimester SSRI exposure.
• Third-trimester SSRI exposure was associated with a higher likelihood of neonatal special or intensive care (aOR 1.6).
• No significant increase in preterm birth, low birth weight, or small for gestational age was found.

Conclusions:

• SSRI use in pregnancy is not independently linked to major malformations or other adverse perinatal outcomes.
• An increased need for neonatal intensive care was observed with third-trimester SSRI exposure.