The use of antidepressants during pregnancy is not linked to a higher overall risk of stillbirth and death in newborns, a study says, confounding a long-held opposing view of such drugs.
The Swedish study of more than 1.6 million births in five Nordic countries included nearly 30,000 women who had filled in a prescription for an SSRI (selective serotonin reuptake inhibitor) during pregnancy.
The researchers found that the 1.79 per cent of mothers exposed to an SSRI had higher rates of stillbirth (4.62 versus 3.69 per 1000) and postneonatal death (1.38 versus 0.96 per 1000) than those who did not.
But the slightly higher rates were attributed to the severity of the underlying psychiatric disease - usually depression - rather than its treatment. Cigarette smoking and the mother's advanced age were also linked to higher deaths.
Mothers exposed to an SSRI and those who were not had a similar rate of neonatal death (2.54 versus 2.21 per 1000). Among the total surveyed group there were 1,633,877 single births, 6054 stillbirths, 3609 neonatal deaths and 1578 postneonatal deaths.
The study "suggests that SSRI use during pregnancy was not associated with increased risks of stillbirth, neonatal death, or postneonatal death," said authors of the research led by Olof Stephansson of the Karolinska Institutet in Stockholm.
"However, decisions regarding use of SSRIs during pregnancy must take into account other perinatal outcomes and the risks associated with maternal mental illness," they said yesterday.
But a US-based expert expressed concern at the findings, to be published in today's edition of The Journal of the American Medical Association.
"This study looked at information on dispensed drugs, not ingested drugs, and these numbers are often quite different," Adam Urato, assistant professor of obstetrics and gynaecology at Tufts University School of Medicine, told WebMD medical news.
"I don't find the study results particularly reassuring," he said.
The women in the study were from Denmark, Finland, Iceland, Norway and Sweden. The data covered different periods from 1996 through 2007.
The use of SSRIs during pregnancy has long been associated with congenital anomalies, neonatal withdrawal syndrome, and pulmonary hypertension of the newborn.