A systematic review 1 including 9 studies with a total of 949 subjects (7 studies, n=699 had control groups) was abstracted in DARE. Prospective cohort studies were eligible for inclusion. Neonates of women taking selective serotonin reuptake inhibitors (SSRIs) during the third trimester of pregnancy were significantly more likely than controls to be low birth weight (OR 3.64, 95% CI 1.01 to 13.08, p=0.0481; NNT 31 based on 837 neonates) or to be admitted to an special care nursery or neonatal intensive care unit (OR 3.30, 95% CI 1.45 to 7.54, p=0.0192; NNT 7 based on 549 neonates). No statistically significant difference was shown in the likelihood of poor neonatal adaptation (OR 4.08, 95% CI 1.20 to 19.93, p=0.0694; n=483) or prematurity (OR 1.85, 95% CI 0.79 to 4.29, p=0.1295; n=909) with SSRIs.
Comment: The quality of evidence is downgraded by poor review methodology. The possibility of subtle adverse effects on the newborn have to be weighted against the benefits achieved with medication in treating severe depression of the mother.
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