title: Effects of timing and duration of gestational exposure to serotonin reuptake inhibitor antidepressants: population-based study.
abstract: BACKGROUND
  Late-gestational serotonin reuptake inhibitor (SRI) exposure has been linked to adverse neonatal outcomes; however, the impact of timing and duration of exposure is unknown.
  
  
  OBJECTIVE
  To determine whether late-gestational exposure to an SRI is associated with increased risk of adverse neonatal outcome relative to early exposure.
  
  
  METHODS
  Population-based maternal and neonatal health records were linked to prenatal maternal prescription records for an SRI medication (n=3500).
  
  
  RESULTS
  After controlling for maternal illness and duration of exposure, using propensity score matching, neonatal outcomes did not differ between late and early exposure (P>0.05). After controlling for maternal illness, longer prenatal exposure increased the risks of lower birth weight, respiratory distress and reduced gestational age (P<0.05).
  
  
  CONCLUSIONS
  Using population health data, length of gestational SRI exposure, rather than timing, increased the risk for neonatal respiratory distress, lower birth weight and reduced gestational age, even when controlling for maternal illness and medication dose. These findings highlight the importance of distinguishing the specific impact of medication exposure from exposure to maternal illness itself.
authors.affiliation: Early Human Experience Unit, Centre for Community Child Health Research, Vancouver, BC, Canada. toberlander@cw.bc.ca
authors.forename: Tim F
authors.initials: TF
authors.lastname: Oberlander
authors.forename: William
authors.initials: W
authors.lastname: Warburton
authors.forename: Shaila
authors.initials: S
authors.lastname: Misri
authors.forename: Jaafar
authors.initials: J
authors.lastname: Aghajanian
authors.forename: Clyde
authors.initials: C
authors.lastname: Hertzman
mesh_terms: D001724:Birth Weight / Q000187:drug effects*; D003627:Data Interpretation, Statistical; D003866:Depressive Disorder / Q000188:drug therapy; D005260:Female; D005865:Gestational Age; D019538:Health Care Surveys; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000139:chemically induced* / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*; D011264:Pregnancy Trimesters; D011297:Prenatal Exposure Delayed Effects / Q000139:chemically induced* / Q000453:epidemiology; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D012720:Severity of Illness Index; D013997:Time Factors
chemical_list: D017367:Selective Serotonin Reuptake Inhibitors