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Use of antidepressants during pregnancy, known as selective serotonin reuptake inhibitors (SSRIs), does not appear to increase the risk of stillbirths or infant deaths, according to the findings of new research.
In a a study published by the Journal of the American Medical Association (JAMA) on January 2, researchers examined more than 1.6 million births in a population-based cohort study, to evaluate the risk of stillbirth or infant death during the first year of life after SSRI antidepressants were used by pregnant women.
Although the findings initially suggested that women who took SSRIs during pregnancy had higher rates of still birth and post-neonatal deaths, after adjusting to account for other variables, such as depression, history of psychiatric disease or previous psychiatric hospitalizations, researchers found no significant association between SSRI use during pregnancy and infant death during the first year of life.
“The increased rates of stillbirth and post-neonatal mortality among infants exposed to an SSRI during pregnancy were explained by the severity of the underlying maternal psychiatric disease and unfavorable distribution of maternal characteristics such as cigarette smoking and advanced maternal age,” wrote study co-authors.
Researchers, led by Dr. Olaf Stephansson of the Karolinska Institute in Stockholm, Sweden, analyzed information from 30,000 women who filled prescriptions for SSRIs in Denmark, Finland, Iceland, Norway and Sweden during 1996 through 2007.
According to information obtained from prescription registries and patient and medical birth registries, researchers determined that approximately 2 percent of the women used SSRIs, such as Prozac or Paxil.
Researchers noted that about 7 to 19 percent of pregnant mothers in economically developed countries are affected by depression.
“Maternal depression is associated with poorer pregnancy outcomes, including increased risk of preterm delivery, which in turn may cause neonatal morbidity and mortality,” wrote the authors.
Antidepressants and Birth Defects
Side effects of antidepressant use during pregnancy have previously been linked to a risk of birth defects, neonatal withdrawal syndrome and pulmonary hypertension, leading researchers to examine if is also a link between antidepressant use and infant deaths.
SSRI antidepressants include some of the most widely prescribed medications in the world, such as Zoloft, Paxil, Celexa and others.
In recent years a number of Zoloft lawsuits and Paxil lawsuits have been filed on behalf of infants diagnosed with severe birth defects or malformations, such as persistent pulmonary hypertension in newborns (PPHN), spina bifida and other health problems.
Prior studies have also raised concerns regarding the use of SSRIs during pregnancy, linking the use of the medications to higher rates of miscarriage, preterm labor, complications during pregnancy and long-term neurobehavioral abnormalities in the babies.
A link has also been identified between antidepressant use during pregnancy and interrupted language development in the babies, autism, seizures and delayed developmental milestones to SSRI use.
Researchers urge doctors and mothers to approach SSRI use carefully and to fully take into account other risks, such as depression, before making a decision about whether to use antidepressants during pregnancy.