Pregnant women who take anti-depressants do not face any increased risk of stillbirth, researchers reported last night.
The findings will help reassure doctors and mothers about the risks of treating women for mental health issues during pregnancy – although the Swedish researchers warned there are other possible side-effects from the drugs to be studied.
Dr Olof Stephansson of the Karolinska Institutet in Sweden and colleagues explain that depression has been linked to premature birth and other risks to the baby, but "it is difficult to disentangle whether such reproductive hazards are caused by the underlying depression, the medical treatment, or lifestyle factors such as stress, alcohol use, and smoking".
Currently in Nordic countries, milder depression in pregnancy is generally not treated with antidepressants. But selective serotonin reuptake inhibitors (SSRIs) are often prescribed for severe depression.
The team investigated the risk of stillbirth and infant death associated with SSRIs during pregnancy using figures on 1,633,877 singleton births in Denmark, Finland, Iceland, Norway, and Sweden from 1996 to 2007.
Just under 2% of the mothers had taken SSRIs during pregnancy. Among these women there was a significantly higher rate of stillbirth, death in the first week, and death in the weeks that followed. But this was fully explained by factors other than SSRI use, such as the severity of the underlying psychiatric disease, cigarette smoking and older age.
Previous hospitalisation for psychiatric disease was also not linked to increased risks to the baby, once other factors were taken into account.
Full details are published in the Journal of the American Medical Association today (January 2). The authors say: "SSRI use during pregnancy was not associated with increased risks of stillbirth, neonatal death, or postneonatal death."
However, they point out: "Decisions about use of SSRIs during pregnancy must take into account other perinatal outcomes and the risks associated with maternal mental illness."
Stephansson, O. et al. Selective Serotonin Reuptake Inhibitors During Pregnancy and Risk of Stillbirth and Infant Mortality. The Journal of the American Medical Association January 2 2013 doi:10.1001/jama.2012.153812
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