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No association between SSRIs and stillbirth, say researchers

There is no significant increase in the likelihood of stillbirth when prescribing SSRIs for pregnant women, say researchers

The study

Scandinavian and US researchers used the national registries in the Nordic countries to identify pregnant women who had received one or more prescriptions for an SSRI from three months before the start of pregnancy until birth. In total they found 1,633,877 births and analysed three outcomes – stillbirth, neonatal death and postneoatal death.

The findings

Pregnant women exposed to SSRIs during pregnancy had a non-significant 17% increase of stillbirth, a non-significant 34% increase of postneonatal death, and a non-significant 23% increase of neonatal death, compared with those not exposed.

There were also non-significant differences when the cohort was stratified for previous hospitalisation for psychiatric disease. Those with previous hospitalisation had an 8% decreased risk of stillbirth, compared to a 7% increase in those who had not been hospitalised, and an 11% decreased risk for neonatal death, compared to a 14% increase in patients without prior hospitalisation.

What does it mean for GPs?

The researchers concluded that the findings from the current study were concurrent with the limited literature on the topic in showing that SSRIs are not associated with increased risk of stillbirths, neonatal death or postneonatal death. However, they cautioned that decisions regarding SSRI use during pregnancy must take into account other perinatal outcomes and the risks associated with maternal mental illness.

JAMA 2013, available online 2 January

Readers' comments (1)

  • But what about congenital defects? I would not use an SSRI in pregnancy. There are other treatments.

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