title: Maternal Use of Selective Serotonin Reuptake Inhibitors and Lengthening of the Umbilical Cord: Indirect Evidence of Increased Foetal Activity-A Retrospective Cohort Study.
abstract: Antenatal depression affects up to 19% of pregnant women. Some of these women are also in need of antidepressant treatment. Nevertheless, the impact of maternal antidepressant treatment and prenatal depression on the course of pregnancy, foetal development and delivery outcomes is not fully understood.
  
  
  
  We analysed data from 24 818 women who gave birth at Kuopio University Hospital between 2002-2012. Logistic regression analysis was used to estimate associations between the use of selective serotonin reuptake inhibitors (SSRIs) during pregnancy and the progression of pregnancy, development of the foetus and delivery outcomes.
  
  
  
  Altogether, 369 (1.5%) women used SSRIs. A regression model adjusted for age, overweight, nulliparity, prior termination, miscarriages, smoking, maternal alcohol consumption, chronic illness and polyhydramnion showed that pregnant women exposed to SSRI medication had significantly lower Apgar scores at 1 minute (p < 0.0001) and 5 minutes (p < 0.0001) and more admissions to the neonatal intensive care unit (p < 0.0001) than unexposed pregnant women. In addition, exposed newborns had longer umbilical cords (p < 0.0001) than non-exposed newborns.
  
  
  
  In addition to the previously known associates with maternal SSRI exposure, such as lowered Apgar scores, SSRI exposure appeared to be associated with increased umbilical cord length. The observation related to increased umbilical cord length may be explained by an SSRI-induced increase in the movements of the developing foetus.
authors.affiliation: Department of Psychiatry, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.
authors.forename: Julia
authors.initials: J
authors.lastname: Kivistö
authors.affiliation: Department of Psychiatry, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.|Department of Psychiatry, Kuopio University Hospital, Kuopio, Finland.
authors.forename: Soili M
authors.initials: SM
authors.lastname: Lehto
authors.affiliation: Department of Pharmacology and Toxicology, University of Eastern Finland, Kuopio, Finland.
authors.forename: Katja
authors.initials: K
authors.lastname: Halonen
authors.affiliation: Department of Obstetrics and Gynaecology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.
authors.forename: Leena
authors.initials: L
authors.lastname: Georgiadis
authors.affiliation: Department of Obstetrics and Gynaecology, Helsinki University Hospital, Helsinki, Finland.|Department of Obstetrics and Gynaecology, University of Helsinki, Helsinki, Finland.
authors.forename: Seppo
authors.initials: S
authors.lastname: Heinonen
mesh_terms: D000293:Adolescent; D000328:Adult; D018687:Antidepressive Agents, Second-Generation / Q000009:adverse effects; D001034:Apgar Score; D015331:Cohort Studies; D003863:Depression / Q000150:complications / Q000188:drug therapy; D005260:Female; D005324:Fetal Movement / Q000187:drug effects*; D006801:Humans; D007231:Infant, Newborn; D008431:Maternal-Fetal Exchange; D015999:Multivariate Analysis; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects*; D014470:Umbilical Cord / Q000187:drug effects* / Q000473:pathology*; D055815:Young Adult
chemical_list: D018687:Antidepressive Agents, Second-Generation; D017367:Selective Serotonin Reuptake Inhibitors