Limits...
Early morbidity and mortality following in utero exposure to selective serotonin reuptake inhibitors: a population-based study in Western Australia.

Colvin L, Slack-Smith L, Stanley FJ, Bower C - CNS Drugs (2012)

Bottom Line: The early years of life have a profound effect on a child's developmental pathway.Mean birth weight, length and APGAR score at 5 minutes were significantly lower in children of women dispensed an SSRI, regardless of whether the SSRI was dispensed in trimester 1, or, trimester 2 or 3 only. 0.9% of the live born children in the SSRI group had died before the age of 1 year compared with 0.5% of the non-SSRI group (odds ratio [OR] 1.8; 95% CI 1.3, 2.6).The most common reason for admission to hospital was acute bronchiolitis (OR 1.6; 95% CI 1.3, 1.8), with an increased risk seen in children of mothers who did not smoke during their pregnancy (OR 1.7; 95% CI 1.4, 2.0).

View Article: PubMed Central - PubMed

Affiliation: Telethon Institute for Child Health Research, Centre for Child Health Research, The University of Western Australia, Perth, Australia. lync@ichr.uwa.edu.au

ABSTRACT

Background: The early years of life have a profound effect on a child's developmental pathway. The children born to mothers suffering from depression may be at risk of increased morbidity and mortality in the first years of life.

Objective: The objective of this study was to investigate the hospital admissions and mortality of children whose mothers were dispensed a selective serotonin reuptake inhibitor (SSRI) during their pregnancy.

Methods: This was a population-based study of all pregnancy events in Western Australia (WA) from 2002 to 2005. The study used linkable state health administrative data from the WA Data Linkage System (WADLS) and the national Pharmaceutical Benefits Scheme (PBS), enabling birth outcomes, hospital admissions and deaths to be ascertained for the children of women dispensed an SSRI during their pregnancy.

Results: There were 3764 children born to 3703 women who had been dispensed an SSRI during their pregnancy (3.8% of all pregnancies in WA, 2002-5), and 94 561 children born to 92 995 women who had not been dispensed an SSRI. Mean birth weight, length and APGAR score at 5 minutes were significantly lower in children of women dispensed an SSRI, regardless of whether the SSRI was dispensed in trimester 1, or, trimester 2 or 3 only. 0.9% of the live born children in the SSRI group had died before the age of 1 year compared with 0.5% of the non-SSRI group (odds ratio [OR] 1.8; 95% CI 1.3, 2.6). Before the age of 2 years, 42.9% of the children in the SSRI group had been admitted to hospital after their birth admission, compared with 34.1% of the non-SSRI group (OR 1.4; 95% CI 1.3, 1.6). The most common reason for admission to hospital was acute bronchiolitis (OR 1.6; 95% CI 1.3, 1.8), with an increased risk seen in children of mothers who did not smoke during their pregnancy (OR 1.7; 95% CI 1.4, 2.0).

Conclusions: The children in the SSRI group were more likely to be admitted to hospital in the first years of life, and this may reflect their prenatal exposure to SSRIs, be related to maternal depression, or SSRI use may be a proxy for an environmental exposure such as smoking, or a combination of these factors. Although the numbers of deaths in the first year of life were small, the increased risk of death in the first year of life in the SSRI group (OR 1.8; 95% CI 1.3, 2.6) is a new finding and should be investigated further.

Show MeSH

Related in: MedlinePlus

Leading ten diagnosis codes of term birth admissions for children in the selective serotonin reuptake inhibitor group, by number of children admitted
© Copyright Policy
Related In: Results  -  Collection


getmorefigures.php?uid=PMC3585696&req=5

Tab4: Leading ten diagnosis codes of term birth admissions for children in the selective serotonin reuptake inhibitor group, by number of children admitted

Mentions: Excluding the regular admission coded for a birth (‘Z38 live born infants according to place of birth’), the ten most common diagnoses recorded on the birth admissions for term births of children in the SSRI group are presented in table IV. The most common diagnosis recorded was ‘Z03 medical observation and evaluation for suspected diseases and conditions’ (OR 1.6; 95% CI 1.4, 1.7). The next most common diagnosis recorded was ‘P22 respiratory distress of newborn’ (OR 1.7; 95% CI 1.5, 2.0) for 7.8% of all children in the SSRI group versus 4.7% of all other children. This is often seen in infants delivered by Caesarean section; however, after adjusting for the type of delivery there was still an increased risk (OR 1.7; 95% CI 1.5, 2.0). This was not seen in the preterm births. Respiratory and cardiovascular disorders specific to the perinatal period (P20-P29) accounted for 13.8% of the diagnoses reported on the birth admission for term births in the SSRI group (OR 1.8; 95% CI 1.6, 2.0) versus 8.2% in the other children. The admissions, ‘P29.3 persistent fetal circulation, delayed closure of ductus arteriosus, pulmonary hypertension of newborn (persistent)’ comprised 0.2% (N = 8) of children in the SSRI group and 0.1% (N = 86) of the non-SSRI group term birth admissions (OR 2.4; 95% CI 1.2, 5.0). After adjusting for Caesarean delivery, the risk of a child in the SSRI group born at term with a diagnosis code of P29.3 being assigned remained at OR 2.4; 95% CI 1.2, 5.0.


Early morbidity and mortality following in utero exposure to selective serotonin reuptake inhibitors: a population-based study in Western Australia.

Colvin L, Slack-Smith L, Stanley FJ, Bower C - CNS Drugs (2012)

Leading ten diagnosis codes of term birth admissions for children in the selective serotonin reuptake inhibitor group, by number of children admitted
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3585696&req=5

Tab4: Leading ten diagnosis codes of term birth admissions for children in the selective serotonin reuptake inhibitor group, by number of children admitted
Mentions: Excluding the regular admission coded for a birth (‘Z38 live born infants according to place of birth’), the ten most common diagnoses recorded on the birth admissions for term births of children in the SSRI group are presented in table IV. The most common diagnosis recorded was ‘Z03 medical observation and evaluation for suspected diseases and conditions’ (OR 1.6; 95% CI 1.4, 1.7). The next most common diagnosis recorded was ‘P22 respiratory distress of newborn’ (OR 1.7; 95% CI 1.5, 2.0) for 7.8% of all children in the SSRI group versus 4.7% of all other children. This is often seen in infants delivered by Caesarean section; however, after adjusting for the type of delivery there was still an increased risk (OR 1.7; 95% CI 1.5, 2.0). This was not seen in the preterm births. Respiratory and cardiovascular disorders specific to the perinatal period (P20-P29) accounted for 13.8% of the diagnoses reported on the birth admission for term births in the SSRI group (OR 1.8; 95% CI 1.6, 2.0) versus 8.2% in the other children. The admissions, ‘P29.3 persistent fetal circulation, delayed closure of ductus arteriosus, pulmonary hypertension of newborn (persistent)’ comprised 0.2% (N = 8) of children in the SSRI group and 0.1% (N = 86) of the non-SSRI group term birth admissions (OR 2.4; 95% CI 1.2, 5.0). After adjusting for Caesarean delivery, the risk of a child in the SSRI group born at term with a diagnosis code of P29.3 being assigned remained at OR 2.4; 95% CI 1.2, 5.0.

Bottom Line: The early years of life have a profound effect on a child's developmental pathway.Mean birth weight, length and APGAR score at 5 minutes were significantly lower in children of women dispensed an SSRI, regardless of whether the SSRI was dispensed in trimester 1, or, trimester 2 or 3 only. 0.9% of the live born children in the SSRI group had died before the age of 1 year compared with 0.5% of the non-SSRI group (odds ratio [OR] 1.8; 95% CI 1.3, 2.6).The most common reason for admission to hospital was acute bronchiolitis (OR 1.6; 95% CI 1.3, 1.8), with an increased risk seen in children of mothers who did not smoke during their pregnancy (OR 1.7; 95% CI 1.4, 2.0).

View Article: PubMed Central - PubMed

Affiliation: Telethon Institute for Child Health Research, Centre for Child Health Research, The University of Western Australia, Perth, Australia. lync@ichr.uwa.edu.au

ABSTRACT

Background: The early years of life have a profound effect on a child's developmental pathway. The children born to mothers suffering from depression may be at risk of increased morbidity and mortality in the first years of life.

Objective: The objective of this study was to investigate the hospital admissions and mortality of children whose mothers were dispensed a selective serotonin reuptake inhibitor (SSRI) during their pregnancy.

Methods: This was a population-based study of all pregnancy events in Western Australia (WA) from 2002 to 2005. The study used linkable state health administrative data from the WA Data Linkage System (WADLS) and the national Pharmaceutical Benefits Scheme (PBS), enabling birth outcomes, hospital admissions and deaths to be ascertained for the children of women dispensed an SSRI during their pregnancy.

Results: There were 3764 children born to 3703 women who had been dispensed an SSRI during their pregnancy (3.8% of all pregnancies in WA, 2002-5), and 94 561 children born to 92 995 women who had not been dispensed an SSRI. Mean birth weight, length and APGAR score at 5 minutes were significantly lower in children of women dispensed an SSRI, regardless of whether the SSRI was dispensed in trimester 1, or, trimester 2 or 3 only. 0.9% of the live born children in the SSRI group had died before the age of 1 year compared with 0.5% of the non-SSRI group (odds ratio [OR] 1.8; 95% CI 1.3, 2.6). Before the age of 2 years, 42.9% of the children in the SSRI group had been admitted to hospital after their birth admission, compared with 34.1% of the non-SSRI group (OR 1.4; 95% CI 1.3, 1.6). The most common reason for admission to hospital was acute bronchiolitis (OR 1.6; 95% CI 1.3, 1.8), with an increased risk seen in children of mothers who did not smoke during their pregnancy (OR 1.7; 95% CI 1.4, 2.0).

Conclusions: The children in the SSRI group were more likely to be admitted to hospital in the first years of life, and this may reflect their prenatal exposure to SSRIs, be related to maternal depression, or SSRI use may be a proxy for an environmental exposure such as smoking, or a combination of these factors. Although the numbers of deaths in the first year of life were small, the increased risk of death in the first year of life in the SSRI group (OR 1.8; 95% CI 1.3, 2.6) is a new finding and should be investigated further.

Show MeSH
Related in: MedlinePlus