Dose-effect of maternal serotonin reuptake inhibitor use during pregnancy on birth outcomes: A prospective cohort study.

by Molenaar, Nina M., Houtman, Diewertje, Bijma, Hilmar H., Brouwer, Marlies E., Burger, Huibert, Hoogendijk, Witte J. G., Bockting, Claudi L. H., Kamperman, Astrid M. and Lambregtse-van den Berg, Mijke P.
Abstract:
BACKGROUND: While antidepressant use during pregnancy is increasingly common, there is concern about the possible effects of in-utero antidepressant exposure on the child. Our objective was to examine whether there is a dose-effect of maternal serotonin reuptake inhibitors (SRI) during pregnancy on birth outcomes. METHODS: Women between 12 and 16 weeks of gestation, who were using an SRI, were eligible for participation in this nation-wide prospective observational cohort study. Recruitment took place between April 2015 and February 2018 (n = 145). SRI exposure and psychopathology symptoms were assessed throughout pregnancy. Exposure was defined as SRI standardized dose at 36 weeks of gestation and mean SRI standardized dose over total pregnancy. Multivariable linear and logistic regression were used to examine the associations with birth weight, gestational age at birth, and being small for gestational age. RESULTS: Maternal SRI dose at 36 weeks of gestation was significantly associated with birth weight (adjusted ß = -180.7, 95%CI -301.1;-60.2, p-value textless 0.01) as was mean SRI standardized dose during total pregnancy (adjusted ß = -187.3, 95%CI -322.0;-52.6, p-value textless 0.01). No significant associations between maternal SRI dose and gestational age or being small for gestational age were observed. LIMITATIONS: Although prospective, we cannot make full causal inferences given that we did not randomize women to different dosages. CONCLUSION: These findings suggest that careful dosing of SRI use during pregnancy may prevent a negative impact on birth weight and indicate the need for further investigation of causality.
Reference:
Dose-effect of maternal serotonin reuptake inhibitor use during pregnancy on birth outcomes: A prospective cohort study. (Molenaar, Nina M., Houtman, Diewertje, Bijma, Hilmar H., Brouwer, Marlies E., Burger, Huibert, Hoogendijk, Witte J. G., Bockting, Claudi L. H., Kamperman, Astrid M. and Lambregtse-van den Berg, Mijke P.), In Journal of affective disorders, volume 267, 2020.
Bibtex Entry:
@article{molenaar_dose-effect_2020,
	title = {Dose-effect of maternal serotonin reuptake inhibitor use during pregnancy on birth outcomes: {A} prospective cohort study.},
	volume = {267},
	copyright = {Copyright © 2020 Elsevier B.V. All rights reserved.},
	issn = {1573-2517 0165-0327},
	doi = {10.1016/j.jad.2020.02.003},
	abstract = {BACKGROUND: While antidepressant use during pregnancy is increasingly common, there is concern about the possible effects of in-utero antidepressant exposure  on the child. Our objective was to examine whether there is a dose-effect of  maternal serotonin reuptake inhibitors (SRI) during pregnancy on birth outcomes.  METHODS: Women between 12 and 16 weeks of gestation, who were using an SRI, were  eligible for participation in this nation-wide prospective observational cohort  study. Recruitment took place between April 2015 and February 2018 (n = 145). SRI  exposure and psychopathology symptoms were assessed throughout pregnancy.  Exposure was defined as SRI standardized dose at 36 weeks of gestation and mean  SRI standardized dose over total pregnancy. Multivariable linear and logistic  regression were used to examine the associations with birth weight, gestational  age at birth, and being small for gestational age. RESULTS: Maternal SRI dose at  36 weeks of gestation was significantly associated with birth weight (adjusted  ß = -180.7, 95%CI -301.1;-60.2, p-value {textless} 0.01) as was mean SRI standardized dose  during total pregnancy (adjusted ß = -187.3, 95%CI -322.0;-52.6, p-value {textless} 0.01).  No significant associations between maternal SRI dose and gestational age or  being small for gestational age were observed. LIMITATIONS: Although prospective,  we cannot make full causal inferences given that we did not randomize women to  different dosages. CONCLUSION: These findings suggest that careful dosing of SRI  use during pregnancy may prevent a negative impact on birth weight and indicate  the need for further investigation of causality.},
	language = {eng},
	journal = {Journal of affective disorders},
	author = {Molenaar, Nina M. and Houtman, Diewertje and Bijma, Hilmar H. and Brouwer, Marlies E. and Burger, Huibert and Hoogendijk, Witte J. G. and Bockting, Claudi L. H. and Kamperman, Astrid M. and Lambregtse-van den Berg, Mijke P.},
	month = apr,
	year = {2020},
	pmid = {32063573},
	note = {Place: Netherlands},
	keywords = {Humans, Female, Pregnancy, *Antidepressants, *Birthweight, *Depression, *Dosage, *Pregnancy, *Prenatal Exposure Delayed Effects, *Serotonin, *Serotonin Uptake Inhibitors/adverse effects, Birth Weight, Child, Gestational Age, Infant, Newborn, Parturition, Prospective Studies},
	pages = {57--62},
}