title: Outcomes of infants exposed to multiple antidepressants during pregnancy: results of a cohort study.
abstract: BACKGROUND
  A single study has been published documenting an increased risk for adverse pregnancy outcomes following use of more than one antidepressant during pregnancy.
  
  
  OBJECTIVE
  To examine whether multiple antidepressant use is associated with increased rates of major malformations, spontaneous abortions (SA), therapeutic abortions (TA), stillbirths, preterm birth, low birth weight, small for gestational age (SGA) and admission to the neonatal intensive care unit (NICU).
  
  
  METHODS
  Information from the Motherisk Program's prospectively collected database of 1243 women with gestational exposure to antidepressants. We compared pregnancy outcomes of 89 women exposed to >1 antidepressants, 89 taking one antidepressant, and 89 women not exposed to antidepressants (n= 267). Women were matched for maternal age, smoking and alcohol use. Groups were compared using odds ratios and ANOVA.
  
  
  RESULTS
  11/89 (12%) took 3 and 78 (88%) took 2 antidepressants. There were no statistically significant differences in any of the outcomes analyzed among the 3 groups except for a lower mean gestational age at birth in the multi-antidepressant group (0.9 week, P=0.036). There were 9 admissions to NICU from the antidepressant groups and 3 from the non-exposed group; but this did not reach statistical significance.
  
  
  CONCLUSIONS
  There is a small risk of preterm delivery that is associated with exposure to antidepressant therapy, although the clinical relevance remains to be determined.
authors.affiliation: The Motherisk Program, The Hospital for Sick Children, Toronto, Canada. einarson@sickkids.ca
authors.forename: A
authors.initials: A
authors.lastname: Einarson
authors.forename: J
authors.initials: J
authors.lastname: Choi
authors.forename: G
authors.initials: G
authors.lastname: Koren
authors.forename: Tr
authors.initials: T
authors.lastname: Einarson
mesh_terms: D000704:Analysis of Variance; D000928:Antidepressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D016208:Databases, Factual; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data; D016017:Odds Ratio; D009864:Ontario / Q000453:epidemiology; D011247:Pregnancy; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000139:chemically induced* / Q000453:epidemiology; D012306:Risk
chemical_list: D000928:Antidepressive Agents