Effects of antidepressant treatment on fetal development and obstetric complications: a retrospective ultrasound...

Antidepressants are commonly used during pregnancy, yet data on their potential effects on fetal growth remain limited, particularly from ultrasound-based studies.

We performed a retrospective analysis of routine ultrasound data from electronic medical records. Data from pregnant women with mental illnesses were extracted and grouped according to antidepressant prescription. After stratifying for gestational age, comparisons between groups included ultrasound parameters, decelerated fetal growth, preterm delivery frequency, ponderal index, blood loss volume at birth and Apgar scores were performed.

We included 44 antidepressant-treated and 80 antidepressant-free patients. Groups did not differ regarding age, BMI, psychiatric diagnoses, smoking status, multiparity or benzodiazepine prescription (p > 0.05 for all). We did not detect differences for estimated fetal weight at any time point or for growth deceleration (p > 0.05), except for biparietal diameter (BPD) values at 5-12 weeks (p = 0.046; higher in the antidepressants-treated group) and BPD percentile values at 13-24 weeks (p = 0.04; lower in the antidepressants-treated group). No differences for preterm delivery frequency or for volume of blood loss at birth were observed (p > 0.05). Severe neonatal distress rates were higher in antidepressant-exposed vs. -unexposed newborns at 5 and 10 min after birth, when using an Apgar score threshold of 7 (p = 0.02 and 0.05 respectively), but not for an Apgar threshold of 4 (p > 0.05).

Antidepressant treatment during pregnancy was not associated with differences in fetal growth or major obstetric outcomes. Small variations observed in BPD are of uncertain significance, and the neonatal Apgar findings were consistent with previously reported mild and transient adaptation symptoms.