Adverse effects of antidepressant use in pregnancy: an evaluation of fetal growth and preterm birth.
OBJECTIVE
To compare the rates of low birth weight, preterm delivery and small for gestational age (SGA), in pregnancy outcomes among women who were exposed and nonexposed to antidepressants during pregnancy.


METHODS
At The Motherisk Program, we analyzed pregnancy outcomes of 1,243 women in our database who took various antidepressants during their pregnancy. Nine hundred and twenty-eight of these women and 928 nonexposed women who delivered a live born infant were matched for age, (+/-2 years), smoking and alcohol use and specific pregnancy outcomes were compared between the two groups.


RESULTS
There were 82 (8.8%) preterm deliveries in the antidepressant group and 50 (5.4%) in the comparison group. OR: 1.7 (95% CI: 1.18-2.45). There were 89 (9.6%) in the antidepressant group and 76 (8.2%) in the comparison group who delivered babies evaluated as SGA; OR: 1.19 (95% CI: 0.86-1.64). The mean birth weight in the antidepressant group was 3,449+/-591 g and 3,455+/-515 g in the comparison group (P=.8).


CONCLUSIONS
The use of antidepressants in pregnancy appears to be associated with a small, but statistically significant increased rate in the incidence of preterm births, confirming results from several other studies. It is difficult to ascertain whether this small increased rate of preterm births is confounded by depression, antidepressants, or both. However, we did not find a statistically significant difference in the incidence of SGA or lower birth weight. This information adds to limited data available in the literature regarding these outcomes following the use of antidepressants in pregnancy.
Einarson
A
A
The Motherisk Program, The Hospital for Sick Children, Toronto, Canada. einarson@sickkids.ca
Choi
J
J
Einarson
T R
TR
Koren
G
G
D000328:Adult; D000928:Antidepressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D005260:Female; D005317:Fetal Growth Retardation / Q000139:chemically induced*; D006801:Humans; D015994:Incidence; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D007752:Obstetric Labor, Premature / Q000139:chemically induced* / Q000453:epidemiology; D009864:Ontario; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D011256:Pregnancy Outcome; D012306:Risk; D013223:Statistics as Topic
D000928:Antidepressive Agents