A register study of the impact of stopping third trimester selective serotonin reuptake inhibitor exposure on neonatal health

• Published in: Acta psychiatrica Scandinavica Vol. 121; no. 6; pp. 471 - 479
• Main Authors: Warburton, W., Hertzman, C., Oberlander, T. F.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.06.2010; Blackwell
• Subjects: Adult; Antidepressive Agents - administration & dosage; Antidepressive Agents - adverse effects; Biological and medical sciences; British Columbia; Case-Control Studies; Depressive Disorder - drug therapy; Depressive Disorder - psychology; Drug toxicity and drugs side effects treatment; Female; Health; Humans; Infant, Newborn; Inhibitor drugs; late prenatal selective serotonin reuptake inhibitor antidepressant exposure; Medical sciences; Miscellaneous (drug allergy, mutagens, teratogens...); Neonatal care; neonatal health; Perinatal Care; Pharmacology. Drug treatments; Pregnancy; Pregnancy Complications - drug therapy; Pregnancy Complications - psychology; Pregnancy Outcome; Pregnancy Trimester, Third - drug effects; Pregnancy Trimester, Third - psychology; prenatal depression; Prenatal Exposure Delayed Effects - prevention & control; Registries; Respiratory Distress Syndrome, Newborn - chemically induced; Respiratory Distress Syndrome, Newborn - prevention & control; Risk Assessment; Serotonin; Serotonin Uptake Inhibitors - administration & dosage; Serotonin Uptake Inhibitors - adverse effects; Severity of Illness Index; Withholding Treatment; Canada; North America; America; British Columbia; Social environment; Neonatal; Psychotropic; Toxicity; Mental health; Pharmacotherapy; Third trimester; Maternal diseases; neonatal health; Selective serotonin reuptake inhibitor; Prenatal; Treatment withdrawal; Antidepressant agent; Respiratory distress; Public health; Human; Mood disorder; Respiratory disease; Depression; Exposure; Retrospective; Pregnancy; Treatment; Newborn; late prenatal selective serotonin reuptake inhibitor antidepressant exposure; Risk factor; prenatal depression
• ISSN: 0001-690X; 1600-0447
• DOI: 10.1111/j.1600-0447.2009.01490.x

Warburton W, Hertzman C, Oberlander TF. A register study of the impact of stopping third trimester selective serotonin reuptake inhibitor exposure on neonatal health. Objective:  To determine whether risk for adverse neonatal outcomes are reduced by stopping SSRI use before the end of pregnancy. Method:  Using population health data, maternal health and prenatal SSRI prescriptions were linked to neonatal birth records (N = 119 547) (1998–2001). Neonates SSRI‐exposed in the last 14 days (L14) of gestation were compared with infants who had gestational exposure, but not during the last 14 days (NL14). Propensity score matching was used to control for potential confounders (total exposure, maternal health characteristics). Results:  Increased risk for neonatal respiratory distress was present where L14 exposure occurred compared with risk where exposure stopped before L14. However, controlling for potential maternal and neonatal confounders, differences disappeared. Conclusion:  Controlling for maternal illness severity, reducing exposure to SSRI’s at the end of pregnancy had no significant clinical effect on improving neonatal health. These findings raise the possibility that some adverse neonatal outcomes may not be an acute pharmacological condition such as toxicity or withdrawal.