Delivery outcome in relation to maternal use of some recently introduced antidepressants

J Clin Psychopharmacol. 2007 Dec;27(6):607-13. doi: 10.1097/jcp.0b013e31815ac4d2.

Abstract

Little is known concerning possible hazards of maternal use of the recently introduced antidepressant drugs with noradrenergic and varying serotonergic activity (serotonin-noradrenaline reuptake inhibitor [SNRI]/noradrenergic reuptake inhibitor [NRI] drugs). Using the Swedish Medical Birth Registry, we identified 732 women who had used SNRI/NRI drugs in early pregnancy. Maternal characteristics were studied as well as delivery outcome: pregnancy duration, birth weight, neonatal diagnoses, infant deaths, and congenital malformations. Comparisons were made with all deliveries in the population (n = 860,215) after adjustment for identified confounders, and risks were expressed as odds ratios or (when numbers were low) as risk ratios. Women using SNRI/NRI deviated from other women by being older, more often having their first infant, being more extensive smokers, having a higher body mass index, and more often being born within Sweden. These characteristics, like the pattern of concomitant drug use, resembled much those of women using selective serotonin reuptake inhibitor (SSRI) drugs. The rate of preterm births was significantly increased (odds ratio, 1.6; 95% confidence interval, 1.19-2.15), and neonatal symptoms such as respiratory problems, low Apgar score, hypoglycemia, and neonatal convulsions showed a similar pattern as seen after maternal SSRI treatment. We found no increased risk for stillbirths or congenital malformations. Delivery outcome after exposure to SNRI/NRI drugs resembles much what has been described after use of SSRI drugs. No signs of teratogenicity were found.

MeSH terms

  • Abnormalities, Drug-Induced / epidemiology
  • Abnormalities, Drug-Induced / etiology
  • Abortion, Spontaneous / epidemiology
  • Abortion, Spontaneous / etiology
  • Adrenergic Uptake Inhibitors / adverse effects
  • Antidepressive Agents / adverse effects*
  • Birth Weight / drug effects
  • Cyclohexanols / adverse effects
  • Databases, Factual / statistics & numerical data
  • Delivery, Obstetric / statistics & numerical data*
  • Female
  • Gestational Age
  • Humans
  • Infant Mortality
  • Infant, Newborn
  • Mianserin / adverse effects
  • Mianserin / analogs & derivatives
  • Mirtazapine
  • Morpholines / adverse effects
  • Pregnancy
  • Pregnancy Trimester, First / drug effects
  • Prenatal Exposure Delayed Effects / chemically induced*
  • Prenatal Exposure Delayed Effects / epidemiology
  • Reboxetine
  • Registries / statistics & numerical data
  • Serotonin Uptake Inhibitors / adverse effects
  • Smoking / adverse effects
  • Sweden / epidemiology
  • Venlafaxine Hydrochloride

Substances

  • Adrenergic Uptake Inhibitors
  • Antidepressive Agents
  • Cyclohexanols
  • Morpholines
  • Serotonin Uptake Inhibitors
  • Mianserin
  • Venlafaxine Hydrochloride
  • Reboxetine
  • Mirtazapine