Antidepressant Use While Pregnant Tied to Lower Risk of Preterm Birth

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Pregnant mothers treated with antidepressants have a lower risk of giving birth prematurely or having a delivery by Caesarean section. However, use of selective serotonin reuptake inhibitors (SSRIs) is associated with a higher risk of neonatal problems, according to a recent study.

Researchers at Columbia University's Mailman School of Public Health, Columbia University Medical Center, and the New York State Psychiatric Institute examined data from Finland involving 845,345 births from 1996-2010 from the Finnish Medical Birth Register. They also looked at data from registers on prescription drug usage and the mothers’ psychiatric history.

The women were then put into different groups: SSRI users, those with a psychiatric diagnosis related to SSRI use but no antidepressant purchases, and those without a diagnosis or antidepressant purchases. A total of 12,817 women in the study had purchased the antidepressants during the first trimester or 30 days before the beginning of gestation, and 9,322 (59%) made two or more purchases.

The risk of preterm birth was 16% lower, and the risk of very preterm birth nearly 50% lower in women using the antidepressants during pregnancy compared to mothers with a psychiatric diagnosis but no medication use, the researchers reported in the American Journal of Psychiatry.

Maternal psychiatric disorder without medication use was associated with an increased risk of Caesarean section (26.5% ) compared to those without a diagnosis or antidepressant purchases (17%).

However, SSRI use was associated with an increased risk of all neonatal problems, including breathing issues,  that led to longer hospital stays and neonatal care.

Risks and Benefits of Antidepressant Use in Pregnancy
Women who were given antidepressants while pregnant were less like to give birth prematurely and deliver by Caesarean section.

Treating maternal psychiatric disorder with commonly used antidepressants is associated with a lower risk of certain pregnancy complications including preterm birth and delivery by Caesarean section, according to researchers at Columbia University's Mailman School of Public Health, Columbia University Medical Center, and the New York State Psychiatric Institute. However, the medications — selective serotonin reuptake inhibitors, or SSRIs — resulted in an increased risk of neonatal problems. Findings are published online in the American Journal of Psychiatry.

The Columbia researchers with colleagues in Finland studied 845,345 single births in 1996 through 2010 from the Finnish Medical Birth Register. They also analyzed data from national registers on prescription drug purchases, mothers' psychiatric history, maternal medical history, hospital sources, and healthcare professionals.

The women were categorized into mutually exclusive groups: SSRI users, those with a psychiatric diagnosis related to SSRI use but no antidepressant purchases, and those without a diagnosis or antidepressant purchases, to determine if outcomes were a result of maternal underlying psychiatric illness or due to use of the drugs.

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