Taking anti-depressants while pregnant won’t increase a woman’s chances of stillbirth, according to a large new study. After looking at nearly 30,000 Nordic women who had taken selective serotonin reuptake inhibitor (SSRI) antidepressants while pregnant, Swedish researchers concluded that there was no significant association between use of these medications and risk of stillbirth, neonatal death or infant death.
The study, published in the January 2 issue of JAMA, included data from more than 1.6 million births, including 6,054 stillbirths, 3,609 neonatal deaths and 1,578 postneonatal deaths.
Women who took SSRIs such as Zoloft, Paxil, Prozac and Lexapro did have higher rates of stillbirth (4.6 vs. 3.7 per 1,000) and postneonatal death (1.38 vs. 0.96 per 1000) than those who did not. But SSRI antidepressants per se were not at fault for the discrepancy.
Study author Olof Stephansson, of Stockholm’s Karolinska Institutet, said that the increased rates of stillbirth and infant death among fetuses exposed to SSRIs can be explained “by the severity of the underlying maternal psychiatric disease and unfavorable distribution of maternal characteristics such as cigarette smoking and advanced maternal age” in depressed mothers.
All decisions regarding use of SSRIs during depression and pregnancy “must take into account other perinatal outcomes” such as birth defects, as well as the risks associated with maternal mental illness,” the researchers concluded.
Antidepressant use during pregnancy can increase risk of fetal birth defects, they note. Taking SSRIs while pregnant “has been associated with congenital abnormalities, neonatal withdrawal syndrome, and persistent pulmonary hypertension of the newborn.” But maternal depression is also associated with poorer pregnancy outcomes.