Maternal use of selective serotonin reuptake inhibitors (SSRI) during pregnancy—neonatal outcomes in correlation with placental histopathology

Michal Levy, Michal Kovo, Hadas Miremberg, Noa Anchel, Hadas Ganer Herman, Jacob Bar, Letizia Schreiber, Eran Weiner

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: We investigated the association between prenatal selective serotonin reuptake inhibitors (SSRI) exposure and pregnancy-outcomes with correlation to placental-histopathology. Study design: Included were pregnancies with maternal SSRI use throughout pregnancy (SSRI-group) and the control group was matched with pregnancies unexposed to SSRI. Placental lesions were classified according to the “Amsterdam” criteria. Adverse neonatal outcome was defined as ≥1 early neonatal-complications. Results: SSRI group had lower birthweights (p < 0.001), higher rates of meconium (p = 0.009), NICU admissions (p < 0.001), and adverse neonatal-outcome (p < 0.001). SSRI placentas had lower birthweight-to-placental-weight ratio (p = 0.02) and higher rates of fetal vascular malperfusion (FVM) lesions (p = 0.03). Using multivariable analyses: GA < 37 weeks (aOR = 2.1, 95%CI 1.7–4.6) and SSRI (aOR = 1.7, 95%CI 1.3–3.9) were independently associated with adverse neonatal outcome while GA < 37 weeks (aOR = 1.6, 95%CI 1.2–3.4), SSRI (aOR = 1.3, 95%CI 1.1–2.6), and smoking (aOR = 1.2, 95%CI 1.1–4.0) were independently associated with FVM lesions. Conclusion: SSRI use during pregnancy was independently associated with adverse neonatal outcome and placental FVM.

Original languageEnglish
Pages (from-to)1017-1024
Number of pages8
JournalJournal of Perinatology
Volume40
Issue number7
DOIs
StatePublished - 1 Jul 2020

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