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Evidence summaries

Selective Serotonin Reuptake Inhibitor (Ssri) Use in Late Pregnancy and Effects on the Newborn

Selective serotonin reuptake inhibitors given in late pregnancy might possibly have subtle adverse effects on the newborn, but there is insufficient evidence from high-quality trials. Level of evidence: "D"

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.

    References

    • Lattimore KA, Donn SM, Kaciroti N, Kemper AR, Neal CR Jr, Vazquez DM. Selective serotonin reuptake inhibitor (SSRI) use during pregnancy and effects on the fetus and newborn: a meta-analysis. J Perinatol 2005 Sep;25(9):595-604. [PubMed] [DARE]

Primary/Secondary Keywords