title: Effect of prenatal selective serotonin reuptake inhibitor (SSRI) exposure on birthweight and gestational age: a sibling-controlled cohort study.
abstract: Up to 10% of women are exposed to selective serotonin reuptake inhibitors (SSRIs) during pregnancy. Information on their effect on birthweight and gestational age remains conflicting. The aim of this sibling-controlled prospective cohort study is to address shared geneticand family-level confounding to investigate the effects of prenatal SSRI exposure and maternal depression on birthweight and gestational age.
  
  
  
  We used the Norwegian Mother and Child Cohort Study (MoBa) and the Medical Birth Registry of Norway (MBRN). Our study population consisted of 27 756 siblings; 194 were prenatally exposed to SSRIs and 27 500 were unexposed to any antidepressant medication. Random and fixed effects analysis with propensity score adjustment was used to evaluate the effectson birthweight and gestational age.
  
  
  
  SSRI exposure during two or more trimesters was associated with a decrease in birthweight of 205 g [95% confidence interval (CI) -372 to - 38] and a decrease in gestational length of 4.9 days (95% CI - 9.1 to - 1.4). Neither maternal SSRI use in one trimester, lifetime history of major depression nor depressive symptoms during pregnancy were associated with these pregnancy outcomes (for non-pharmacologically treated depression in two periods in pregnancy, +5 g (95% CI - 56 to + 67) and +4.9 days (95% CI - 4.7 to + 14.7), respectively).
  
  
  
  Prenatal exposure to SSRIs during two or more trimesters may decrease birthweight and gestational length. Our results indicate that neither maternal depression nor shared genetics and family environment fully explain this association.
authors.affiliation: PharmacoEpidemiology and Drug Safety Research Group, School of Pharmacy, University of Oslo, Oslo, Norway.
authors.forename: Katerina
authors.initials: K
authors.lastname: Nezvalová-Henriksen
authors.affiliation: Department of Clinical Pharmacology, St Olav's University Hospital, Trondheim, Norway.|Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: Olav
authors.initials: O
authors.lastname: Spigset
authors.affiliation: PharmacoEpidemiology and Drug Safety Research Group, School of Pharmacy, University of Oslo, Oslo, Norway.|Domain for Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway.
authors.forename: Ragnhild Eek
authors.initials: RE
authors.lastname: Brandlistuen
authors.affiliation: Domain for Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway.|Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway.
authors.forename: Eivind
authors.initials: E
authors.lastname: Ystrom
authors.affiliation: Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.
authors.forename: Gideon
authors.initials: G
authors.lastname: Koren
authors.affiliation: PharmacoEpidemiology and Drug Safety Research Group, School of Pharmacy, University of Oslo, Oslo, Norway.|Domain for Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway.
authors.forename: Hedvig
authors.initials: H
authors.lastname: Nordeng
mesh_terms: D000328:Adult; D001724:Birth Weight; D003865:Major Depressive Disorder / Q000188:drug therapy*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D016014:Linear Models; D016015:Logistic Models; D008431:Maternal-Fetal Exchange; D009664:Norway / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*; D011256:Pregnancy Outcome; D057216:Propensity Score; D011446:Prospective Studies; D012042:Registries; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D035781:Siblings
chemical_list: D017367:Selective Serotonin Reuptake Inhibitors
keywords: SSRIs; birthweight; depression; gestational age; sibling design