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A review of the safety of selective serotonin reuptake inhibitors during pregnancy

✍ Scribed by David J. Goldstein; Karen Sundell

Publisher
John Wiley and Sons
Year
1999
Tongue
English
Weight
89 KB
Volume
14
Category
Article
ISSN
0885-6222

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✦ Synopsis

Antidepressant treatment may be desirable or necessary during pregnancy; however, the bene®t of treatment must balance the bene®ts to the mother with any risk to the developing fetus. In order to make educated, patient-speci®c, bene®t-to-risk assessments, an understanding of possible risks associated with in-utero antidepressant exposure is important. We reviewed all published cohort-controlled studies (n 4) and prospective surveys (n 5) regarding SSRI use in pregnancy. Outcomes from over 1000 ¯uoxetine-exposed pregnancies, more than for any other antidepressant, indicate that ®rst trimester ¯uoxetine exposure does not statistically signi®cantly increase risk for spontaneous abortion or major malformation. Outcomes from nearly 300 pregnancies exposed to another SSRI (sertraline, paroxetine, or ¯uvoxamine) suggest the same conclusion. Following in-utero SSRI exposure, birthweight, rates of prematurity, and postnatal complications appear similar to control values. Preschool age children exposed to ¯uoxetine in-utero show no signi®cant dierences from controls in global IQ, language, or behavior; such long-term data are not available for other SSRIs. The substantial clinical experience with ¯uoxetine-exposed pregnancies and the preliminary data regarding other SSRIs is reassuring when considering depression treatment for women of childbearing potential.

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