An international research team has found that the use of selective serotonin reuptake inhibitor (SSRI) antidepressants during pregnancy is linked to a higher risk of gestational diabetes and early adaptation issues in newborns, even after accounting for maternal depression. The study also indicated that SSRI use during pregnancy may lower the risks of preterm birth and low birth weight.
The population-based study revealed that pregnant women using SSRIs had an increased risk of developing gestational diabetes compared to those with depression who did not take medication. However, these women experienced a lower risk of caesarean section, very preterm birth, and both low and very low birth weight.
In terms of newborn outcomes, exposure to SSRIs was associated with higher chances of low Apgar scores at one and five minutes after birth, respiratory problems, and greater need for neonatal or intensive care unit treatment. The research did not find an increased risk for major congenital malformations among babies exposed to SSRIs in utero.
Comparisons between women who continued SSRI use during pregnancy and those who stopped before becoming pregnant showed that ongoing medication was linked to reduced risks of late preterm birth and low birth weight. Nevertheless, the heightened risks related to early adaptation problems in newborns persisted regardless of when SSRI use was discontinued.
Docent Heli Malm, lead author of the study, stated: "Our results emphasise the significance of individualized treatment decisions during pregnancy. The treatment of depression is important, and the use of SSRIs seems to protect against the risk of preterm birth associated with depression. At the same time, however, it is necessary to closely monitor both the progress of the pregnancy and the health of the newborn."
Malm added: "The association we have observed with gestational diabetes requires further research in order to better understand the possible cause-and-effect relationship and underlying biological mechanisms."
The collaborative effort involved researchers from the Research Centre for Child Psychiatry at Finland's University of Turku and Columbia University in New York. The analysis drew on national registry data covering more than 1.27 million children born in Finland from 1996 through 2018.
To strengthen their findings, researchers compared mothers using SSRIs during pregnancy with two other groups: women diagnosed with depression who did not take antidepressants while pregnant and those who discontinued SSRI use before conception. Sibling comparisons were also employed to account for hereditary factors and shared environmental influences.
The primary goal was to clarify whether previously reported prenatal risks stemmed from antidepressant medications themselves or from maternal depression severity. Researchers adjusted their analyses for several indicators reflecting how severe each mother's depression was.
The Research Centre for Child Psychiatry operates as part of INVEST Research Flagship Centre under Finland’s Research Council.
