Published studies were considered eligible if they examined exposure
to antidepressant medication use during pregnancy and reported data on at least one birth outcome of
interest: PTB (b37 weeks gestation) or LBW (b2500 g). Of the 222 reviewed studies, 28 published studies met
the selection criteria.
Data Extraction: Two authors independently extracted study characteristics from eligible studies.
Results: Using random-effects models, antidepressant use in pregnancy was significantly associated with LBW
(RR: 1.44, 95% confidence interval (CI): 1.21-1.70) and PTB (RR: 1.69, 95% CI: 1.52-1.88). Studies varied widely
in design, populations, control groups and methods. There was a high level of heterogeneity as measured by
I2 statistics for both outcomes examined. The relationship between antidepressant exposure in pregnancy and
adverse birth outcomes did not differ significantly when taking into account drug type (SSRI vs. other or mixed)
or study design (prospective vs. retrospective). There was a significant association between antidepressant
exposure and PTB for different types of control status used (depressed, mixed or nondepressed).