In a newly published report, researchers evaluated national-registry data from Denmark, Finland, Iceland, Norway, and Sweden to determine the effect of selective serotonin reuptake inhibitors (SSRIs) on pregnancy outcomes. Data on mothers with infants born between 1996 and 2007 were collected, although the periods from which data were included varied by country depending on the years prescribing data were available. Drug exposure was defined as having filled one or more SSRI prescriptions as early as three months before pregnancy. Women who were prescribed fluoxetine, citalopram, paroxetine, sertraline, fluvoxamine, or escitalopram were studied; women taking other antidepressants were excluded. Pregnancy outcomes were categorized as stillborn (intrauterine death after 22 or 28 weeks, depending on the country), neonatal death (death occurring within 27 days of birth), and postneonatal death (death occurring between 28 and 364 days after birth).

Citalopram was the most frequently taken SSRI, followed by fluoxetine and sertraline. Compared with women who didn't take SSRIs, those who did tended to be older, to smoke, and to have been hospitalized previously for a psychiatric illness; they were also more likely to have diabetes or hypertension.

A total of 29,228 births occurred to women taking SSRIs during pregnancy, accounting for almost 2% of the 1,633,877 births overall. Women taking SSRIs experienced higher crude rates of stillbirth and postneonatal death, but not neonatal death. The higher rates were no longer evident, however, after adjustment for maternal characteristics, country, and birth year, nor did stratification by previous psychiatric hospitalization result in a significant association between SSRI exposure and stillbirth, neonatal death, or postneonatal death.

Reference