Obstetrical and neonatal outcomes after prenatal exposure to selective serotonin reuptake inhibitors: The relevance of dose

Antenatal Exposure to Selective Serotonin Reuptake Inhibitors and Duration of Gestation

“…When these data were available and the difference was statistically significant, the degree of earlier birth associated with SSRI exposure (relative to SSRI-unexposed women, regardless of presence of depression) was in the region of 2-6 days, 3,5,7,8,16,18 with most studies finding smaller rather than greater differences. In a systematic review and meta-analysis of 15 studies, Ross et al 19 found that gestational age was 3.2 (95% CI, 1.8-4.5) days shorter in women exposed to antidepressants relative to women in control groups; there was little difference in analyses restricted to different sets of controls.…”

“…Some, [1][2][3][4][5][6][7][8][9][10] but not all, [11][12][13][14][15][16][17] studies suggest that the use of SSRIs during pregnancy increases the risk of preterm delivery; in the positive studies, the risk appears to be approximately doubled, on average, in SSRIexposed relative to unexposed women. An important limitation of these studies is that all were observational in design.…”

Fetal Effects of Selective Serotonin Reuptake Inhibitor Treatment During Pregnancy: Immediate and Longer Term Child Outcomes

“…SSRIs An increased prevalence of reduced gestational age at birth following SSRI exposure was reported in seven studies investigating SSRI exposed cohorts [19][20][21][22][23][24] . SSRI exposure was also associated with a higher prevalence of preterm birth in five identified studies 20,[24][25][26][27] .…”

“…SSRI exposure was also associated with a higher prevalence of preterm birth in five identified studies 20,[24][25][26][27] . Not all, however, confirmed such an association, with seven studies failing to replicate an association [28][29][30][31][32][33][34] .…”

“…The study by Oberlander et al 22 employed a large record linkage design (n = 1575 early exposed and 1925 later exposed), with prospective ascertainment of information through medical records and found an association between length of SSRI exposure and gestational age at birth. Several studies reported that continuous or later gestational exposure was associated with reduced gestational age 20,22 and led to higher rates of preterm birth 24 . One study that investigated the effect of dose of SSRI concluded that only higher than average doses were associated with premature delivery and reduced gestational age 24 , however the slightly larger study by Hendrick et al 29 failed to find an association.…”