RT Journal
A1 El Marroun H, Jaddoe VV, Hudziak JJ, et al
T1 MAternal use of selective serotonin reuptake inhibitors, fetal growth, and risk of adverse birth outcomes
JF Archives of General Psychiatry
JO Archives of General Psychiatry
YR 2012
FD July 1
VO 69
IS 7
SP 706
OP 714
DO 10.1001/archgenpsychiatry.2011.2333
UL http://dx.doi.org/10.1001/archgenpsychiatry.2011.2333
AB Context 
                  Selective serotonin reuptake inhibitors (SSRIs) are frequently prescribed to pregnant women, but knowledge about their unintended effects on child health is scarce.Objective 
                  To examine the effects of maternal SSRI use during pregnancy on fetal growth and birth outcomes.Design 
                  The study was embedded in the Generation R Study, a prospective population-based study from fetal life onward.Participants 
                  Seven thousand six hundred ninety-six pregnant women were included. Selective serotonin reuptake inhibitor use was assessed by questionnaires in each trimester and verified by pharmacy records. Using depressive symptom scores from the Brief Symptom Inventory, 7027 pregnant mothers (91.3%) had no or low depressive symptoms, 570 pregnant mothers (7.4%) had clinically relevant depressive symptoms and used no SSRIs, and 99 pregnant mothers (1.3%) used SSRIs.Main Outcome Measures 
                  Fetal ultrasonography was performed in each trimester. We determined fetal body and head growth with repeated assessments of body and head size. The birth outcomes studied were preterm birth, small for gestational age, and low birth weight.Results 
                  Fetuses from mothers with prenatal depressive symptoms showed reduced body growth (β = −4.4 g/wk; 95% CI: −6.3 to −2.4; P < .001) and head growth (β = −0.08 mm/wk; 95% CI: −0.14 to −0.03; P = .003). Mothers using SSRIs during pregnancy had fewer depressive symptoms than mothers in the clinical symptom range. Prenatal SSRI use was not associated with reduced body growth but was associated with reduced fetal head growth (β = −0.18 mm/wk; 95% CI: −0.32 to −0.07; P = .003). The SSRI-exposed children were at higher risk for preterm birth (odds ratio = 2.14; 95% CI: 1.08 to 4.25; P = .03).Conclusions 
                  Untreated maternal depression was associated with slower rates of fetal body and head growth. Pregnant mothers treated with SSRIs had fewer depressive symptoms and their fetuses had no delay in body growth but had delayed head growth and were at increased risk for preterm birth. Further research on the implications of these findings is needed.