Do SSRIs Raise PTB Risk?

Dr. Chapa’s Clinical Pearls.

Depressive disorders during pregnancy are common, with estimated prevalence ranging from 11% to 16%. Accordingly, antidepressant drugs, most commonly selective serotonin reuptake inhibitors (SSRI), are used by approximately 3–4% of pregnant women worldwide, with a higher prevalence in the United States compared to Europe. As antidepressants cross the placenta and the fetal blood-brain barrier, exposure during pregnancy raises concerns of potential risks of adverse pregnancy outcomes. On August 30, 2024, a new study was released ahead of print in the AJOG. This confirmed the reduction in preterm birth risk with effective mental health counseling approaches; HOWEVER, it also concluded that “use of antidepressants during pregnancy was associated with an increased 31% risk of pre-delivery independent of underlying depression “. Do SSRI meds increase preterm labor risk by 31%?! This is indirect contrast to a separate publication published just six months earlier, in February 2024 in a separate journal. In this episode, we will discuss this very important topic of SSRI use in pregnancy and the preterm birth risk.