TOPLINE:

Among pregnant women diagnosed with depression, the use of selective serotonin reuptake inhibitors (SSRIs) was associated with higher odds of gestational diabetes and neonatal adaptation problems and lower odds of preterm birth after accounting for the severity of maternal depression.

METHODOLOGY:

• Researchers conducted a population-based birth cohort study to evaluate whether the use of SSRIs during pregnancy was associated with adverse pregnancy and neonatal outcomes when treating maternal depression.
• They used linked data from national registers of singleton live births in Finland and included 19,020 SSRI users, of whom 6903 were diagnosed with depression; 19,625 women with depression who did not use antidepressants; and 1,053,280 unexposed women between 1996 and 2018.
• SSRI users were women who purchased two or more SSRIs from 30 days before pregnancy until the end of pregnancy. Unexposed women were those who neither purchased antidepressants nor had depression at any time prior to or during pregnancy until discharge (≤ 3 weeks) from the hospital after delivery.
• Researchers compared pregnancy and neonatal outcomes among SSRI users, women with depression who did not use antidepressants, and unexposed women.

TAKEAWAY:

• After adjusting for indicators of maternal depression severity, women with depression who used SSRIs had 20% higher odds of gestational diabetes than those who did not use antidepressants (P < .001).
• Women with depression who used SSRIs had 45% lower odds of very preterm birth, 33% lower odds of low birth weight, and 54% lower odds of very low birth weight than those who did not use antidepressants (P < .05 for all).
• Infants exposed to SSRIs had approximately twofold higher odds of a low 5-minute Apgar score, 67% higher odds of breathing problems, and 39% higher odds of neonatal care unit monitoring than those from mothers with depression but no use of antidepressants (P < .05 for all).
• Compared with unexposed women, those who used SSRIs had a modestly increased risk for gestational diabetes and neonatal complications but a lower risk for small for gestational age and very low birth weight.

IN PRACTICE:

"[The study] results provide reassurance that SSRI use during pregnancy does not increase the risk of preterm birth and may even be associated with a reduced risk of preterm birth when treating maternal depression. Given the increased risk of problems related to neonatal adaptation, neonatal monitoring remains important," the authors wrote.

SOURCE:

This study was led by Heli Malm, MD, PhD, Research Centre for Child Psychiatry, University of Turku, Turku, Finland. It was published online on February 04, 2026, in the American Journal of Obstetrics & Gynecology MFM.

LIMITATIONS:

As depression symptoms were not measured directly, the severity of depression could not be assessed from registry data. The observational nature of the study limited causal interference.

DISCLOSURES:

This study was supported by the National Institute of Mental Health of the National Institutes of Health. One author reported being the CEO of Digifamilies Inc.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.