Women who take certain antidepressants while pregnant do not raise the risk of a stillbirth or death of their baby in the first year of life, according to a large new study, published Tuesday in Journal of American Medical Association.
SSRIs (selective serotonin reuptake inhibitors) ease depression by affecting chemical messengers (neurotransmitters) used to communicate between brain cells. Most antidepressants work by changing the levels of one or more of these naturally occurring brain chemicals.
SSRIs approved by the Food and Drug Administration to treat depression, with their generic names followed by brand names in parentheses, include:
- Citalopram (Celexa)
- Escitalopram (Lexapro)
- Fluoxetine (Prozac, Prozac Weekly, Sarafem)
- Paroxetine (Paxil, Paxil CR, Pexeva)
- Sertraline (Zoloft)
- Fluoxetine combined with the atypical antipsychotic olanzapine (Symbyax)
The researchers found no notable link between SSRI drug use and risk of neonatal death, postneonatal death, or stillbirth, even after controlling for variables such as maternal psychiatric disease.
The relative risks of neonatal death, postneonatal death, and stillbirth linked to SSRI exposure during pregnancy were approximated by the scientists, while adjusting for variables including prior psychiatric hospitalization and maternal characteristics.
Results showed that out of the 1,633,877 births examined, there were 3,609 neonatal deaths, 1,578 postnatal deaths, and 6,054 stillbirths. There were 1.79% (29,228) of women who were taking SSRI drugs during pregnancy.
The SSRI group and the group who was not exposed to the drugs had similar rates of neonatal death (2.54 vs. 2.21 per 1000). "Yet in multivariate models (such as women who smoke and take SSRIs), SSRI use was not associated with stillbirth, neonatal death, or postneonatal death, suggesting that SSRI use during pregnancy was not associated with increased risks of stillbirth, neonatal death, or postneonatal death," said authors of the research led by Olof Stephansson of the Karolinska Institutet in Stockholm.
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