Antidepressant Exposure and Adverse Neonatal Outcomes: A Population-Based Cohort Study [ID 1507]

INTRODUCTION: Antenatal depression has increased and is associated with adverse maternal and child health outcomes. West Virginia has the highest prevalence of depression in the United States. This study aimed to estimate the effect of antidepressant in utero exposure on neonatal outcomes in the rural state of West Virginia. METHODS: A population-based study was performed using surveillance data (Project WATCH) of live singleton births in West Virginia from 2020 to 2023 (N=67,714). Outcomes included gestational age as a binary (preterm birth [less than 37 weeks] versus term birth [greater than/equal to 37 weeks]) and continuous variable (days) and birth weight as a binary (low birth weight [less than 2,500 g] versus normal/high birth weight [greater than/equal to 2,500 g]) and continuous variable (grams). Regression analyses were performed to estimate the effect of in utero exposure. RESULTS: There were 457 cases of in utero exposure to antidepressants with 263 (58%) cases being antidepressants alone. The adjusted analysis results showed that the antidepressant exposure group had a mean gestational age reduction of 8.36 days (−9.63, −7.08) and a mean birth weight reduction of 202.12 g (−253.08, −151.17). The adjusted odds of preterm birth increased by 3.03 (2.45, 3.74) and low birth weight increased by 2.55 (2.01, 3.23). CONCLUSIONS/IMPLICATIONS: Low birth weight and preterm birth are associated with health issues. Current recommendations suggest antidepressants may be a superior treatment depending on patient factors. Doctors and patients should discuss to decide on antenatal antidepressant use. More research is needed to better understand antenatal antidepressant use, especially for those with substance use during pregnancy.