Prenatal SSRI Use Impacts Fetal Head Growth, Preterm Birth

But untreated maternal depression also affects fetal growth pattern

THURSDAY, March 8 (HealthDay News) -- Untreated maternal depression is linked to reduced fetal head and body growth, while use of selective serotonin reuptake inhibitors (SSRIs) during pregnancy improves symptoms of depression but results in reduced head growth and an increased risk of preterm birth, according to research published online March 5 in the Archives of General Psychiatry.

Hanan El Marroun, Ph.D., of Sophia Children's Hospital in Rotterdam, Netherlands, and colleagues conducted a prospective, population-based study involving 7,696 pregnant women to examine the effects of SSRI use during pregnancy on fetal growth and birth outcomes, including preterm birth, small for gestational age, and low birth weight. Of these women, 7,027 had no or low depressive symptoms, 570 had clinically relevant depressive symptoms but did not use SSRIs, and 99 used SSRIs during pregnancy. Fetal body and head growth were determined each trimester using ultrasonography.

The researchers found that the fetuses of mothers with depressive symptoms, but who did not use SSRIs, displayed significantly reduced body and head growth. Mothers who used SSRIs during pregnancy exhibited fewer depressive symptoms, and their fetuses had significantly reduced fetal head, but not body, growth. There was a significantly increased risk of preterm birth in SSRI-exposed infants (odds ratio, 2.14).

"Our findings further raise the question whether maternal SSRI treatment during pregnancy is better or worse for the fetus than untreated maternal depression. Clinicians must carefully weigh the known risks of untreated depression during pregnancy and the possible adverse effects of SSRIs," the authors write.

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