Maternal Use of Selective Serotonin Reuptake Inhibitors and Lengthening of the Umbilical Cord: Indirect Evidence of Increased Foetal Activity-A Retrospective Cohort Study

• Published in: PloS one 2016-04, Vol.11 (4), p.e0154628
• Main Authors: Kivistö, Julia, Lehto, Soili M, Halonen, Katja, Georgiadis, Leena, Heinonen, Seppo
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Age; Alcohol use; Alcoholic beverages; Analysis; Antidepressants; Antidepressive Agents, Second-Generation - adverse effects; Apgar Score; Biology and Life Sciences; Birth weight; Body weight; Care and treatment; Chronic diseases; Chronic illnesses; Clinical medicine; Cohort analysis; Cohort Studies; Data processing; Depression (Mood disorder); Depression - complications; Depression - drug therapy; Dosage and administration; Drugs; Exposure; Female; Fetal development; Fetal Movement - drug effects; Fetuses; Gynecology; Health aspects; Hospitals; Humans; Infant, Newborn; Inhibitors; Maternal-Fetal Exchange; Medicine and Health Sciences; Mental depression; Midwifery; Miscarriage; Multivariate Analysis; Neonates; Newborn babies; Obstetrics; Overweight; Placenta; Preeclampsia; Pregnancy; Pregnancy Complications - drug therapy; Pregnancy Outcome; Pregnant women; Premature birth; Prenatal depression; Psychiatry; Questionnaires; Regression analysis; Regression models; Retrospective Studies; Risk factors; Serotonin; Serotonin uptake inhibitors; Serotonin Uptake Inhibitors - adverse effects; Smoking; Studies; Systematic review; Ultrasonic imaging; Umbilical cord; Umbilical Cord - drug effects; Umbilical Cord - pathology; Womens health; Young Adult
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0154628

Antenatal depression affects up to 19% of pregnant women. Some of these women are also in need of antidepressant treatment. Nevertheless, the impact of maternal antidepressant treatment and prenatal depression on the course of pregnancy, foetal development and delivery outcomes is not fully understood. We analysed data from 24 818 women who gave birth at Kuopio University Hospital between 2002-2012. Logistic regression analysis was used to estimate associations between the use of selective serotonin reuptake inhibitors (SSRIs) during pregnancy and the progression of pregnancy, development of the foetus and delivery outcomes. Altogether, 369 (1.5%) women used SSRIs. A regression model adjusted for age, overweight, nulliparity, prior termination, miscarriages, smoking, maternal alcohol consumption, chronic illness and polyhydramnion showed that pregnant women exposed to SSRI medication had significantly lower Apgar scores at 1 minute (p < 0.0001) and 5 minutes (p < 0.0001) and more admissions to the neonatal intensive care unit (p < 0.0001) than unexposed pregnant women. In addition, exposed newborns had longer umbilical cords (p < 0.0001) than non-exposed newborns. In addition to the previously known associates with maternal SSRI exposure, such as lowered Apgar scores, SSRI exposure appeared to be associated with increased umbilical cord length. The observation related to increased umbilical cord length may be explained by an SSRI-induced increase in the movements of the developing foetus.