Selective serotonin reuptake inhibitors and adverse pregnancy outcomes

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American Journal of Obstetrics and Gynecology

Volume 194, Issue 4 , April 2006, Pages 961-966

Copyright © 2006 Mosby, Inc. All rights reserved.

Selections from the 26th Annual Meeting of the Society for Maternal-

Fetal Medicine, January 30-February 4th, 2006, Miami, Florida

Selective serotonin reuptake inhibitors and adverse pregnancy

outcomes

Shi Wu Wen MB, PhDa, b, c, , , Qiuying Yang MD, PhDa, b, d,

Garner MD†, Fraser MD, MSce, Olufemi Olatunbosun MDf, Carl

Nimrod MDa, b and Mark MSc, MDa, b

aOMNI Research Group, Department of Obstetrics and Gynecology,

University of Ottawa Faculty of Medicine

bOttawa Health Research Institute, Clinical Epidemiology Program

cDepartment of Epidemiology and Community Medicine, University of

Ottawa Faculty of Medicine

dMcLauhlin Centre for Population Health Risk Assessment, Institute

of Population Health, University of Ottawa, Ottawa, Ontario, Canada

eDepartment of Obstetrics and Gynecology, University of Montreal

Faculty of Medicine, Montreal, Quebec, Canada

fDepartment of Obstetrics and Gynecology, University of Saskatchewan

Faculty of Medicine, Saskatoon, Saskatchewan, Canada

Received 2 December 2005; revised 16 January 2006; accepted 12

February 2006. Available online 30 March 2006.

Objective

The purpose of this study was to assess the safety of the use of

selective serotonin reuptake inhibitors in pregnancy.

Study design

We carried out a retrospective cohort study of 972 pregnant women

who had been given at least 1 selective serotonin reuptake inhibitor

prescription in the year before delivery and 3878 pregnant women who

did not receive selective serotonin reuptake inhibitors and who were

matched by the year of the infant's birth, the type of institute at

birth, and the mother's postal code from 1990 to 2000 in the

Canadian province of Saskatchewan.

Results

The risks of low birth weight (adjusted odds ratio, 1.58; 95% CI,

1.19, 2.11), preterm birth (adjusted odds ratio, 1.57; 95% CI, 1.28,

1.92), fetal death (adjusted odds ratio, 2.23; 95% CI, 1.01, 4.93),

and seizures (adjusted odds ratio, 3.87; 95% CI, 1.00, 14.99) were

increased in infants who were born to mothers who had received

selective serotonin reuptake inhibitor therapy.

Conclusion

The use of selective serotonin reuptake inhibitors in pregnancy may

increase the risks of low birth weight, preterm birth, fetal death,

and seizures.

Key words: Depression; Serotonin reuptake inhibitor; Pregnancy;

Fetus; Birth defect; Low birth weight; Preterm birth; Fetal death;

Seizure

Supported by a grant from The Hospital for Sick Kids Foundation

(grant #XG-02-098) and by a research and development Research

Allowance from The Canadian Institutes for Health Research

(S.W.W.).Based in part on nonidentifiable data provided by the

Saskatchewan Department of Health. The interpretation and

conclusions contained herein do not necessarily represent those of

the Government of Saskatchewan or the Saskatchewan Department of

Health.Presented at the 26th Annual Meeting of the Society for

Maternal Fetal Medicine, January 30 - February 4, 2006, Miami, FL.

Reprint requests: Shi Wu Wen, MB, PhD, OMNI Research Group,

Department of Obstetrics & Gynecology, University of Ottawa, Faculty

of Medicine, 501 Smyth Rd, Box 241, Ottawa, Ontario, Canada, K1H 8L6.

† Deceased

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