Outcomes of prenatal antidepressant exposure

Gregory E. Simon, Michael L. Cunningham, Robert Davis

Research output: Contribution to journalArticle

291 Citations (Scopus)

Abstract

Objective: This study evaluated the effects of prenatal antidepressant exposure on perinatal outcomes, congenital malformations, and early growth and development. Method: Within a group-model health maintenance organization, all infants with apparent prenatal exposure to tricyclic or selective serotonin reuptake inhibitor (SSRI) antidepressants were frequency matched to an unexposed comparison group by year of birth, maternal age, and mother's lifetime use of antidepressant drugs and mental health care. A structured blind review of mothers' and infants' medical records examined perinatal outcomes, congenital malformations, and developmental delay. Results: Tricyclic antidepressant exposure was not associated with any significant difference in perinatal outcomes. Exposure to SSRIs was associated with a 0.9-week decrease in mean gestational age, a 175-g decrease in mean birth weight, and a 0.29 decrease in mean Apgar score at 5 minutes, but differences in birth weights and Apgar scores were not significant after adjustment for gestational age. Differences in gestational age and birth weights were unrelated to length of exposure, but differences in Apgar scores were limited to those with third-trimester exposure. Neither tricyclic antidepressant nor SSRI exposure was significantly associated with congenital malformations or developmental delay. Conclusions: The authors found no association between tricyclic antidepressant or SSRI exposure and either congenital malformations or developmental delay. SSRI exposure during pregnancy was associated with earlier delivery and consequent lower birth weight. Third-trimester SSRI exposure was also associated with lower Apgar scores. Women considering taking SSRIs during pregnancy may balance any higher fetal risk against the risk of persistent or recurrent depression.

Original languageEnglish (US)
Pages (from-to)2055-2061
Number of pages7
JournalAmerican Journal of Psychiatry
Volume159
Issue number12
DOIs
StatePublished - Dec 1 2002

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Serotonin Uptake Inhibitors
Apgar Score
Antidepressive Agents
Birth Weight
Tricyclic Antidepressive Agents
Gestational Age
Third Pregnancy Trimester
Mothers
Pregnancy
Health Maintenance Organizations
Maternal Age
Growth and Development
Medical Records
Mental Health
Parturition
Depression
Delivery of Health Care

All Science Journal Classification (ASJC) codes

  • Psychiatry and Mental health

Cite this

Outcomes of prenatal antidepressant exposure. / Simon, Gregory E.; Cunningham, Michael L.; Davis, Robert.

In: American Journal of Psychiatry, Vol. 159, No. 12, 01.12.2002, p. 2055-2061.

Research output: Contribution to journalArticle

Simon, Gregory E. ; Cunningham, Michael L. ; Davis, Robert. / Outcomes of prenatal antidepressant exposure. In: American Journal of Psychiatry. 2002 ; Vol. 159, No. 12. pp. 2055-2061.
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