CNS Update: Serotonergic Antidepressant Use in Pregnancy and Risk of Seizures in Children


eMediNexus    10 February 2023

A study evaluated if the children born to women using serotonergic antidepressants during pregnancy contain a higher risk of neonatal seizures and epilepsy.


Swedish register-based data was employed to examine associations between maternal reported use of selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs) in pregnancy and diagnosis of neonatal seizures or epilepsy in >1.2 million children. To account for systematic differences between exposed and unexposed children, a wide range of measured confounders were adjusted. After first assessing the role of maternal indication for SSRI/SNRI use (i.e., depression or anxiety) and parental epilepsy, the remaining parental background factors (e.g., age, comorbidities, education, and family socioeconomic indices) and pregnancy-specific characteristics (e.g., maternal use of other psychotropic medications and tobacco smoking in early pregnancy) were adjusted.


Compared with all other children, children of women using SSRI/SNRI in pregnancy showed an elevated risk of neonatal seizures and epilepsy. The estimates of association were found to decrease by adjustment for maternal indications for SSRI/SNRI use, but not by additional adjustment for parental history of epilepsy. Full adjustment for all measured parental and pregnancy-specific factors caused a marked reduction of the remaining associations.


Thus, no support was found regarding the concern that maternal SSRI/SNRI use in pregnancy raises childrens risk for neonatal seizures or epilepsy.


This study provided Class II evidence that exposure to SSRIs/SNRIs in the first trimester of pregnancy is not linked with an elevated incidence of neonatal seizures/epilepsy.


Source: Neurology Jun 2022, 98 (23) e2329-e2336; DOI: 10.1212/WNL.0000000000200516

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