Maternal SSRI Use, Mental Illness, and Pregnancy Outcomes

Robert L. Barbieri, MD reviewing Malm H et al. Am J Psychiatry 2015 Aug 4.

Women with untreated psychiatric illness (but not those who used selective serotonin reuptake inhibitors) had excess risk for preterm birth.

To address the ongoing question of whether pregnancy complications in women with psychiatric disorders are linked to selective serotonin reuptake inhibitors (SSRIs) or underlying psychopathology, Finnish investigators conducted a national study in which outcomes of 845,345 singleton pregnancies were compared among women who filled SSRI prescriptions during pregnancy (SSRI), those with mental health diagnoses who did not fill such prescriptions (untreated), and those who neither filled SSRI prescriptions nor had mental health diagnoses (unexposed).

The SSRI group had significantly higher rates of 5-minute Apgar scores <7 and newborn breathing problems than both the untreated and unexposed groups. Both the SSRI and untreated groups had significantly higher rates of newborn hospitalization for >7 days than the unexposed group. Compared with unexposed women, those in the SSRI group were not at increased risk for preterm birth. However, women in the untreated group had significantly higher risk for preterm birth than those in both the SSRI and unexposed groups.

Citation(s):

Malm H et al. Pregnancy complications following prenatal exposure to SSRIs or maternal psychiatric disorders: Results from population-based national register data. Am J Psychiatry 2015 Aug 4; [e-pub].