Selective Serotonin Reuptake Inhibitors in Human Pregnancy: To Treat or Not to Treat?

Selective serotonin reuptake inhibitors (SSRIs) are increasingly prescribed during pregnancy. The purpose of the present paper is to summarize and evaluate the current evidence for the risk/benefit analysis of SSRI use in human pregnancy. The literature has been inconsistent. Although most studies h...

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Main Authors: Orna Diav-Citrin, Asher Ornoy
Format: Article
Language:English
Published: Wiley 2012-01-01
Series:Obstetrics and Gynecology International
Online Access:http://dx.doi.org/10.1155/2012/698947
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author Orna Diav-Citrin
Asher Ornoy
author_facet Orna Diav-Citrin
Asher Ornoy
author_sort Orna Diav-Citrin
collection DOAJ
description Selective serotonin reuptake inhibitors (SSRIs) are increasingly prescribed during pregnancy. The purpose of the present paper is to summarize and evaluate the current evidence for the risk/benefit analysis of SSRI use in human pregnancy. The literature has been inconsistent. Although most studies have not shown an increase in the overall risk of major malformations, several studies have suggested that SSRIs may be associated with a small increased risk for cardiovascular malformations. Others have noted associations between SSRIs and specific types of rare major malformations. In some studies, there appears to be a small increased risk for miscarriages, which may be associated with the underlying maternal condition. Neonatal effects have been described in up to 30% of neonates exposed to SSRIs late in pregnancy. Persistent pulmonary hypertension of the newborn has also been described with an absolute risk of <1%. The risk associated with treatment discontinuation, for example, higher frequency of relapse and increased risk of preterm delivery, should also be considered. The overall benefit of treatment seems to outweigh the potential risks.
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spelling doaj-art-47f48266c2c94e3d813225460809b0612025-02-03T01:03:18ZengWileyObstetrics and Gynecology International1687-95891687-95972012-01-01201210.1155/2012/698947698947Selective Serotonin Reuptake Inhibitors in Human Pregnancy: To Treat or Not to Treat?Orna Diav-Citrin0Asher Ornoy1The Israeli Teratology Information Service, Israel Ministry of Health, P.O. Box 1176, Jerusalem 91010, IsraelThe Israeli Teratology Information Service, Israel Ministry of Health, P.O. Box 1176, Jerusalem 91010, IsraelSelective serotonin reuptake inhibitors (SSRIs) are increasingly prescribed during pregnancy. The purpose of the present paper is to summarize and evaluate the current evidence for the risk/benefit analysis of SSRI use in human pregnancy. The literature has been inconsistent. Although most studies have not shown an increase in the overall risk of major malformations, several studies have suggested that SSRIs may be associated with a small increased risk for cardiovascular malformations. Others have noted associations between SSRIs and specific types of rare major malformations. In some studies, there appears to be a small increased risk for miscarriages, which may be associated with the underlying maternal condition. Neonatal effects have been described in up to 30% of neonates exposed to SSRIs late in pregnancy. Persistent pulmonary hypertension of the newborn has also been described with an absolute risk of <1%. The risk associated with treatment discontinuation, for example, higher frequency of relapse and increased risk of preterm delivery, should also be considered. The overall benefit of treatment seems to outweigh the potential risks.http://dx.doi.org/10.1155/2012/698947
spellingShingle Orna Diav-Citrin
Asher Ornoy
Selective Serotonin Reuptake Inhibitors in Human Pregnancy: To Treat or Not to Treat?
Obstetrics and Gynecology International
title Selective Serotonin Reuptake Inhibitors in Human Pregnancy: To Treat or Not to Treat?
title_full Selective Serotonin Reuptake Inhibitors in Human Pregnancy: To Treat or Not to Treat?
title_fullStr Selective Serotonin Reuptake Inhibitors in Human Pregnancy: To Treat or Not to Treat?
title_full_unstemmed Selective Serotonin Reuptake Inhibitors in Human Pregnancy: To Treat or Not to Treat?
title_short Selective Serotonin Reuptake Inhibitors in Human Pregnancy: To Treat or Not to Treat?
title_sort selective serotonin reuptake inhibitors in human pregnancy to treat or not to treat
url http://dx.doi.org/10.1155/2012/698947
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AT asherornoy selectiveserotoninreuptakeinhibitorsinhumanpregnancytotreatornottotreat