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Use of New SSRIs in Pregnancy Appears Safe.

The selective serotonin reuptake inhibitors (SSRIs) dominate treatment of depression. In a recent study, use of the SSRI fluoxetine during pregnancy was associated with minor but not major birth anomalies (see JW Nov 1 1996, p. 168, and N Engl J Med 1996; 335:1010). This prospective, multicenter, controlled cohort study compared pregnancy outcomes in 267 women exposed to the newer SSRIs fluvoxamine, paroxetine, and sertraline during the first trimester of pregnancy with outcomes in 267 controls exposed to agents known not to be teratogenic. All the women had contacted one of nine participating Teratology Information Service centers.

Women exposed to SSRIs were less likely to be primigravid, and were more likely to smoke cigarettes and to have had a prior abortion. Exposure to SSRIs was not associated with an increased risk for major malformations (rate for both groups, roughly 4 percent) or low birthweight. Rates of stillbirth, miscarriage, and prematurity also were similar between cases and controls.

Comment: These findings are important because many pregnancies are unplanned, and women taking SSRIs may become pregnant before they have had a chance to consider whether to stop taking these drugs. The data support the safety of the newer SSRIs in pregnancy.

— TH Lee

Published in Journal Watch General Medicine March 3, 1998

Citation(s):

Kulin NA et al. Pregnancy outcome following maternal use of the new selective serotonin reuptake inhibitors: A prospective controlled multicenter study. JAMA 1998 Feb 25 279 609-610.

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