Table 4.
Adjusted odds ratio and absolute risk difference of adverse birth outcomes among children of mothers with continued antidepressant use, compared with mothers with discontinued antidepressant use by type of antidepressant exposure
| Birth outcomes | SSRIs only (N=16,429) * | Non-SSRIs only (N=3,700) * | SSRIs and non-SSRIs (N=1,785) * | |||
|---|---|---|---|---|---|---|
| aOR β (95% CI) | aAbsolute risk difference % (95% CI) | aOR β (95% CI) | aAbsolute risk difference % (95% CI) | aOR β (95% CI) | aAbsolute risk difference % (95% CI) | |
| Gestational age (days) ┼ | −1.8 (−2.1; −1.6) | - | −4.0 (−4.6; −3.5) | - | −3.3 (−4.0; −2.6) | - |
| Birthweight (g) ┼ | −45.8 (57.3; −34.2) | - | −67.6 (−89.1; −46.0) | - | −73.8 (−101.7; −45.8) | - |
| Extremely preterm (<28 weeks) | 0.82 (0.53; 1.25) | −0.1 (−0.2; 0.1) | 1.31 (0.71; 2.42) | 0.1 (−0.1; 0.3) | 0.90 (0.35; 2.32) | −0.1 (−0.3; 0.2) |
| Very preterm (28–32 weeks) | 1.05 (0.82; 1.34) | 0.0 (−0.2; 0.2) | 1.86 (1.33; 2.59) | 0.5 (0.1; 0.9) | 1.18 (0.68; 2.02) | 0.1 (−0.3; 0.5) |
| Moderate to late preterm (32–37 weeks) | 1.28 (1.18; 1.39) | 1.4 (0.9; 1.9) | 2.08 (1.84; 2.35) | 5.0 (4.0; 6.0) | 1.66 (1.39; 1.98) | 3.2 (1.9; 4.5) |
| Very low birthweight (<1500 g) | 0.95 (0.75; 1.20) | −0.1 (−0.2; 0.1) | 1.27 (0.89; 1.80) | 0.2 (−0.2; 0.5) | 0.98 (0.57; 1.68) | 0 .0 (−0.5; 0.4) |
| Low birthweight (1500–2499g) | 1.20 (1.08; 1.32) | 0.7 (0.3; 1.1) | 1.61 (1.39; 1.87) | 2.2 (1.4; 3.0) | 1.40 (1.13; 1.74) | 1.5 (0.4; 2.5) |
| Small for gestational age | 0.99 (0.91; 1.08) | −0.1 (−0.1; 0.0) | 0.97 (0.80; 1.13) | −0.2 (−0.8; 0.4) | 1.04 (0.85; 1.28) | 0.3 (−0.8; 1.3) |
| Postnatal adaptation syndrome | 2.51 (1.79; 3.50) | 0.5 (0.3;0.6) | 3.05 (1.91; 4.87) | 0.6 (0.4; 0.8) | 2.48 (1.49; 4.13) | 0.5 (0.2; 0.7) |
| Persistent pulmonary hypertension of the neonate | 1.16 (0.75; 1.79) | 0.0 (−0.1; 0.1) | 1.57 (0.86; 2.88) | 0.1 (−0.1; 0.3) | 1.57 (0.72; 3.42) | 0.1 (−0.1; 0.3) |
| Neonatal admission | 1.43 (1.35; 1.51) | 5.3 (5.1; 5.4) | 1.85 (1.68; 2.03) | 9.7 (8.7; 10.6) | 1.79 (1.57; 2.03) | 9.0 (7.5; 10.5) |
| Congenital malformations | 1.01 (0.91; 1.12) | 0.0 (−0.4; 0.4) | 1.13 (0.95; 1.34) | 0.5 (−0.2; 1.2) | 1.10 (0.86; 1.40) | 0.4 (−0.6; 1.4) |
Children born to mothers who discontinued antidepressants were the comparison group.
SSRIs only—Children born to mothers who used selective serotonin reuptake inhibitors during pregnancy
Non-SSRIs —Children born to mothers who used non-selective serotonin reuptake inhibitors during pregnancy
SSRIs and non-SSRIs—Children born to mothers who used both SSRIs and non-SSRIs during pregnancy, which could be due to switching or polytherapy.
OR= odds ratio; aOR= adjusted odds ratio; aAbsolute risk difference= adjusted absolute risk difference; Adjusted for maternal age at delivery, primiparity, maternal psychiatric history at delivery, maternal inpatient and outpatient treatment from 1 year before pregnancy to delivery, dispensing of other psychotropic prescriptions during pregnancy, dispensing of antiepileptic prescriptions during pregnancy, number of maternal non-psychiatric hospital visits during pregnancy, smoking during pregnancy, marital status at delivery, highest education at delivery, and calendar year of delivery.
Adjusted mean differences, β-coefficients were estimated for gestational age and birth weight as continuous variables.