Selective serotonin reuptake inhibitor use in third trimester of pregnancy and birth outcomes after vaginal birth – a Swedish retrospective register study 2005–2015

INTRODUCTION: Selective serotonin reuptake inhibitors (SSRIs) are prescribed for depression during pregnancy, yet the impact on maternal and neonatal outcomes remains insufficiently studied. The study aimed to describe the prevalence of prescribed SSRIs to pregnant women and its association with birth outcomes after a vaginal birth. METHODS: < 0.001. RESULTS: SSRIs were prescribed to 6.374 women (1.6%), with prevalence rising from 0.3% to 2.6% between 2005 and 2015. SSRI was associated with significantly higher rates of labor induction, epidural anesthesia and PPH > 1000 mL. postpartum. Women prescribed SSRIs were more likely to give birth at 37-38 weeks' gestation and have neonates with head circumference < 35 cm and with Apgar score < 7 at 5 min. CONCLUSIONS: SSRI prescriptions increased significantly between 2005 and 2015 and were associated with higher risks of adverse maternal and neonatal outcomes. Until more conclusive evidence is availble midwives and obstetricians should remain vigilant when supporting pregnant women with depression or anxiety, considering the potential risks of pharmacological treatment alongside non-pharmacological management of maternal mental health conditions.