title: Obstetrical and neonatal outcomes after prenatal exposure to selective serotonin reuptake inhibitors: the relevance of dose.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the effects of prenatal exposure to selective serotonin reuptake inhibitors (SSRIs) on obstetrical and neonatal outcomes.
  
  
  METHODS
  A case-control study was conducted to compare perinatal outcomes among pregnant women with affective disorder (DSM-IV criteria) and who received SSRIs during pregnancy with those of women without an active psychiatric disorder during pregnancy who were non-exposed to antidepressants during pregnancy. Each case was matched to two controls for maternal age (± 2 years) and parity.
  
  
  RESULTS
  A total of 252 women were enrolled in the study, 84 exposed and 168 non-exposed. Demographic and clinical characteristics did not differ significantly between the groups. The rates of prelabor rupture of membranes, induction of labor and cesarean delivery were slightly higher but not statistically significant in the exposed group. The mean gestational age at birth was 38.8 (± 1.86) weeks for the exposed group and 39.4 (± 1.52) weeks for the non-exposed group (p=.005). Rates for preterm birth were higher in the exposed group (OR=3.44, 95% CI=1.30-9.11). After stratification for dose, it was found that exposure to a high-dose was associated with lower gestational age (p=.009) and higher rates of prematurity (OR=5.07, 95% CI=1.34-19.23). The differences remained significant after controlling for maternal status and the length of exposure.
  
  
  CONCLUSIONS
  Women treated with SSRIs during pregnancy, mainly at high-dose, had an increased risk of preterm birth compared to healthy women of similar age and parity who were not exposed to SSRI during pregnancy.
authors: Perinatal Psychiatry Program, Institut Clinic of Neuroscience (ICN), Hospital Clínic, Barcelona, Spain. alba.roca@yahoo.es
authors: A
authors: A
authors: Roca
authors: Ll
authors: L
authors: Garcia-Esteve
authors: M L
authors: ML
authors: Imaz
authors: A
authors: A
authors: Torres
authors: S
authors: S
authors: Hernández
authors: F
authors: F
authors: Botet
authors: E
authors: E
authors: Gelabert
authors: S
authors: S
authors: Subirà
authors: A
authors: A
authors: Plaza
authors: M
authors: M
authors: Valdés
authors: R
authors: R
authors: Martin-Santos
mesh_terms: D000293:Adolescent; D000328:Adult; D000928:Antidepressive Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D001008:Anxiety Disorders / Q000188:drug therapy*; D016022:Case-Control Studies; D002585:Cesarean Section; D003866:Depressive Disorder / Q000188:drug therapy*; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000139:chemically induced; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D019964:Mood Disorders / Q000188:drug therapy; D010298:Parity; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy* / Q000523:psychology; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000139:chemically induced* / Q000453:epidemiology; D012306:Risk; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D000928:Antidepressive Agents; D017367:Selective Serotonin Reuptake Inhibitors