title: Maternal depression, antidepressant use in pregnancy and Apgar scores in infants.
abstract: BACKGROUND
  Use of antidepressants during pregnancy has been associated with a low Apgar score in infants but a contribution from the underlying depressive disorder might influence this association.
  
  
  OBJECTIVE
  To estimate the effects of maternal depression and use of antidepressants during pregnancy on low Apgar scores (<7) 5 min after birth.
  
  
  METHODS
  Register study on all pregnant women in Denmark from 1996 to 2006 linking nationwide individualised data from the Medical Birth Register, the Psychiatric Central Register and the National Prescription database.
  
  
  RESULTS
  Infants exposed to antidepressants during pregnancy had an increased rate of a low Apgar score (odds ratio (OR) = 1.72, 95% CI 1.34-2.20). The increased rate was only found among infants exposed to selective serotonin reuptake inhibitors (SSRIs) (OR = 1.96, 95% CI 1.52-2.54), not among those exposed to newer (OR = 0.83, 95% CI 0.40-1.74) or older antidepressants (OR = 0.53, 95% CI 0.19-1.45). Maternal depression before or during pregnancy, without prescription of antidepressants, was not associated with a low Apgar score (OR = 0.44, 95% CI 0.11-1.74). Women who had only used antidepressants prior to pregnancy had no increased rate of a low Apgar score in their subsequent pregnancy, regardless of depression status.
  
  
  CONCLUSIONS
  Use of SSRIs during pregnancy increases the risk of a low Apgar score independently of maternal depression.
authors: Psychiatric Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark.
authors: Hans Mørch
authors: HM
authors: Jensen
authors: Randi
authors: R
authors: Grøn
authors: Øjvind
authors: Ø
authors: Lidegaard
authors: Lars Henning
authors: LH
authors: Pedersen
authors: Per Kragh
authors: PK
authors: Andersen
authors: Lars Vedel
authors: LV
authors: Kessing
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000009:adverse effects*; D001034:Apgar Score; D003865:Major Depressive Disorder / Q000188:drug therapy*; D005260:Female; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*; D011264:Pregnancy Trimesters; D011297:Prenatal Exposure Delayed Effects; D012044:Regression Analysis; D012307:Risk Factors; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects*
chemical_list: D000928:Antidepressive Agents; D017367:Selective Serotonin Reuptake Inhibitors