Scripties UMCG - Rijksuniversiteit Groningen
English | Nederlands

Antidepressant exposure during pregnancy and its effect on pregnancy and birth outcomes: a population-based cohort study

(2019) Croes, N.F. (Nicolle)

Objective- To determine whether SSRI use is associated with adverse pregnancy and birth
Methods- We carried out a Dutch-population based retrospective cohort study from 1999-
2014. Data was collected by the PHARMO and PRN databases on 33559 pregnant females.
Data of females with registered SSRI dispensation (before, during or after pregnancy) were
matched (ratio 1:4) with data of females with no SSRI dispensation by birth year of the
female, birth year of the child, nulliparity and pharmacy region. Two study groups were
identified: SSRI users during pregnancy (SU+, n=2466) and non-SSRI users during
pregnancy (SU-, n=31402).
Results- SSRI users were generally older, had more parities and were more often of low SES
(socio-economic status). Furthermore, they had a higher incidence of concomitant use of
psychotropic medication. Antidepressant users had a shorter length of gestation (ßAdjusted -
0.37, 95% CI [-0.43, -0.26]) and their infants had lower birth weight (ßAdjusted -78.54, 95% CI
[-103.89, -53.18]). Moreover, a higher risk of prematurity (<37 weeks) (ORAdjusted 1.24, 95%
CI [1.07, 1.44], p <.001) was observed. No association was seen between SSRI use and an
increased risk of SGA infants (small for gestational age: birth weight <10th percentile)
(ORAdjusted 1.11, 95% CI [0.96, 1.28], p >.05).
Conclusion- The use of SSRI in pregnancy may be associated with shorter length of
gestation, lower birth weight and prematurity, which may be interrelated to one another.

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