Meta-Analysis: Antidepressant Use During Pregnancy Increased Pre-Term Delivery

Women who continued use of antidepressant medications during their pregnancies had an increased risk for preterm delivery and low birth weight, according to a meta-analysis (Selected pregnancy and delivery outcomes after exposure to antidepressant medication) and published online in JAMA: Psychiatry. However, the researchers emphasized that the increased risk was small and that physicians and patients “must weigh the effect of untreated maternal depression against the potential adverse effects of antidepressant exposure.”

The researchers included 23 studies that reported outcomes associated with pharmacologic treatment during pregnancy.

Analysis of data from 13 studies that looked at the association between antidepressant use and preterm delivery, an increased pooled odds ratio of 1.55 (P<.001) for preterm delivery was found for women who used antidepressants compared with those who did not. A similar association was found for antidepressant use and risk for young gestational age, with women on antidepressants having a mean difference of -0.45 weeks (P<.001).

Finally, antidepressant use was associated with a mean difference of -74 grams birth weight compared to women who were not on antidepressants. However, when women on antidepressants were compared with women with depression no association with decreased birth weight was found.

“In contrast, the results for gestational age, preterm delivery, and Apgar scores (at 1 and 5 minutes) were similar whether the control group was all mothers or only depressed mothers, although the sample size was reduced for the latter comparison,” the researchers wrote. “This similarity suggests that exposure to antidepressants may be the determining factor for these detrimental pregnancy and delivery outcomes.”

The abstract can be read, here.