Delivery outcome after the use of antidepressants in early pregnancy

• Published in: European journal of clinical pharmacology 1999-09, Vol.55 (7), p.503-508
• Main Authors: ERICSON, A, KÄLLEN, B, WIHOLM, B.-E
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Antidepressants; Antidepressive Agents - adverse effects; Antidepressive Agents - therapeutic use; Biological and medical sciences; Birth Weight - drug effects; Drug therapy; Embryonic and Fetal Development - drug effects; Female; Gestational Age; Humans; Infant Mortality; Infant, Newborn; Infant, Newborn, Diseases - chemically induced; Infant, Newborn, Diseases - mortality; Maternal Age; Medical sciences; Middle Aged; Neuropharmacology; Odds Ratio; Parity; Pharmacology. Drug treatments; Pregnancy; Pregnancy Outcome; Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease); Psychology. Psychoanalysis. Psychiatry; Psychopharmacology; Serotonin Uptake Inhibitors - adverse effects; Serotonin Uptake Inhibitors - therapeutic use; Smoking; Twins
• ISSN: 0031-6970; 1432-1041
• DOI: 10.1007/s002280050664

To investigate delivery outcome after the use of antidepressants in early pregnancy. Using an ongoing prospective recording of drug use in early pregnancy, 969 women were identified who reported the use of antidepressants: 531 used only SSRI (selective serotonin re-uptake inhibitor) drugs (mostly citalopram, 375 exposures), 423 used only other antidepressants, and 15 used both. Outcome was compared with all births in the population. Women using these drugs were older and smoked more than three times as often as other women. There seemed to be an excess of high parity women. The frequency of multiple births was lower than expected, resulting from too few twin births in women who had used SSRI. Gestational duration among singletons was shorter but it did not affect infant survival and was similar after the use of SSRI or non-SSRI antidepressants, perhaps the result of uncompensated for confounding or related to the underlying disease. Infants were somewhat heavier than expected, notably after non-SSRI treatment. No increase was seen in congenital abnormalities, observable in the perinatal period. Based on this database, the use of antidepressants in early pregnancy does not seem to carry any significant risk for the infant that is detectable during the newborn period.