SSRI use during pregnancy and risk of stillbirth and neonatal mortality.
OBJECTIVE
The authors investigated whether in utero exposure to selective serotonin reuptake inhibitors (SSRIs) increases the risk of stillbirth or neonatal mortality.


METHODS
The authors conducted a population-based cohort study using the Danish Fertility Database to identify every birth in Denmark between 1995 and 2008. Time of exposure to SSRIs was calculated on the basis of standard treatment dosages and dispensed pack sizes according to the prescription register. Exposure was divided into first-, second-, and third-trimester exposure. Multivariate logistic regression models were used.


RESULTS
The authors identified 920,620 births; the incidence of stillbirths was 0.45%, and the incidence of neonatal mortality was 0.34%. A total of 12,425 offspring were exposed to an SSRI during pregnancy. Stillbirth was not associated with first-trimester SSRI use (adjusted odds ratio=0.77, 95% CI=0.43-1.36), first- and second-trimester use (odds ratio=0.84, 95% CI=0.40-1.77), or first-, second-, and third-trimester use (odds ratio=1.06, 95% CI=0.71-1.58). Neonatal mortality was not associated with SSRI first-trimester use (odds ratio=0.56, 95% CI=0.25-1.24), first- and second-trimester use (odds ratio=0.90, 95% CI=0.37-2.17), or first-, second-, and third-trimester use (odds ratio=1.27, 95% CI=0.82-1.99).


CONCLUSIONS
This study found no association between exposure to SSRIs during pregnancy and stillbirth or neonatal mortality.
Laboratory of Clinical Pharmacology, Rigshospitalet, Copenhagen. espen.jimenez.solem@rh.regionh.dk
Espen
E
Jimenez-Solem
Jon Trærup
JT
Andersen
Morten
M
Petersen
Kasper
K
Broedbaek
Anders Rune
AR
Lander
Shoaib
S
Afzal
Christian
C
Torp-Pedersen
Henrik E
HE
Poulsen
D000328:Adult; D000928:Antidepressive Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003718:Denmark; D003866:Depressive Disorder / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D005260:Female; D005865:Gestational Age; D006801:Humans; D015994:Incidence; D007226:Infant Mortality; D007231:Infant, Newborn; D016017:Odds Ratio; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*; D012042:Registries; D012307:Risk Factors; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D050497:Stillbirth / Q000453:epidemiology*; D055815:Young Adult
D000928:Antidepressive Agents; D017367:Selective Serotonin Reuptake Inhibitors