Pub Date : 2026-02-04DOI: 10.1016/j.ajogmf.2026.101910
Heli Malm, Alan S Brown, Keely Cheslack-Postava, Mika Gissler, David Gyllenberg, Emmi Heinonen, Susanna Hinkka-Yli-Salomäki, Ian W McKeague, Aleksi Tornio, Subina Upadhyaya, Andre Sourander
Background: Maternal underlying depression may confound previously reported associations between SSRI use and adverse pregnancy and neonatal outcomes.
Objective: To determine whether SSRI use during pregnancy is associated with an increased risk of pregnancy and neonatal complications after adjusting for indicators of maternal depression severity.
Study design: This population-based birth cohort study used data from national registers in Finland and included 1,272,587 singleton live births from 1996 to2018. Pregnancy outcome of women with two or more SSRI purchases during pregnancy (N=19,020) were compared to women with a diagnosis of depression but no antidepressant use (N=19,625), and women who discontinued SSRIs before pregnancy (n=3,145). Analyses included adjustment for several indicators of depression severity, and within-family sibling comparisons.
Results: After adjusting for confounders and comparing to women with depression who did not use antidepressants, maternal SSRI use was associated with an increased risk of gestational diabetes (OR 1.14; 95% CI 1.07-1.22), while the risk of caesarean section (CS), late (32-36+6 weeks' gestation) and very preterm birth (<32 weeks' gestation), small for gestational age (SGA), and low and very low birth weight was lower. Among SSRI-exposed infants, risk of a low (<7) 5-minute Apgar score (OR 2.02; 95% CI 1.78-2.30), breathing problems (OR 1.61; 95% CI 1.48-1.75), and neonatal care unit (NCU) treatment (OR 1.23; 95% CI 1.16-1.31) was higher, whereas the risk of hospital stay at 7 days and major congenital anomalies was lower. Third-trimester exposure further increased the risk of a low 5-minute Apgar score (OR 3.44; 95% CI 2.93-4.04). After adjustment for indicators of depression severity, the increased risk of gestational diabetes persisted (OR 1.20; 95% CI 1.09-1.32) as did the lower risk of CS, very preterm birth, and low and very low birth weight, and the risks of a low 5-minute Apgar score, breathing problems, and NCU treatment remained higher. Compared to women who discontinued SSRI use before pregnancy, SSRI use was associated with lower risks of late preterm birth and low birth weight (OR 0.83; 95% CI 0.70-0.999 and OR 0.78; 95% CI 0.64-0.96, respectively), while the neonatal risks described above remained elevated. In the sibling-pair analysis, SSRI use was associated with an increased risk of gestational diabetes and neonatal complications other than malformations, including an increased risk of needing hospital stay at 7 days of age.
Conclusions: SSRI use during pregnancy affects neonatal health beyond maternal depression by increasing symptoms related to delayed neonatal adaptation, although it may reduce the risk of preterm birth. The observed increase in the risk of gestational diabetes warrants further study. VIDEO ABSTRACT.
背景：母体潜在抑郁可能混淆先前报道的SSRI使用与不良妊娠和新生儿结局之间的关联。目的：在调整了孕产妇抑郁严重程度指标后，确定孕期使用SSRI是否与妊娠和新生儿并发症风险增加相关。研究设计：这项基于人口的出生队列研究使用了芬兰国家登记册的数据，包括1996年至2018年的1,272,587名单胎活产婴儿。将怀孕期间购买两次或两次以上SSRI的妇女（N=19,020）与诊断为抑郁症但未使用抗抑郁药的妇女（N=19,625）和怀孕前停用SSRIs的妇女（N= 3,145）进行比较。分析包括对抑郁症严重程度的几个指标的调整，以及家庭内部兄弟姐妹的比较。结果：在调整混杂因素并与未使用抗抑郁药物的抑郁症妇女进行比较后，母亲使用SSRI与妊娠糖尿病风险增加相关(OR 1.14；95% CI 1.07-1.22)，而剖宫产（CS）、妊娠晚期（32-36+6周）和非常早产的风险(结论：妊娠期间使用SSRI会增加与新生儿延迟适应相关的症状，从而影响新生儿健康，尽管它可能降低早产风险。观察到的妊娠糖尿病风险增加值得进一步研究。视频摘要。
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Pub Date : 2026-02-03DOI: 10.1016/j.ajogmf.2026.101907
Megan E Graeff, Suneet P Chauhan, Aaron W Roberts
{"title":"Support for Universal Third Trimester Ultrasound from Risk Factor-Based Analysis.","authors":"Megan E Graeff, Suneet P Chauhan, Aaron W Roberts","doi":"10.1016/j.ajogmf.2026.101907","DOIUrl":"https://doi.org/10.1016/j.ajogmf.2026.101907","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":" ","pages":"101907"},"PeriodicalIF":3.1,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146126614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"In reply: Interpretation of subgroup findings and methodologic considerations in the cerclage individual patient data meta-analysis.","authors":"Vincenzo Berghella, Gabriele Saccone, Rupsa Boelig","doi":"10.1016/j.ajogmf.2025.101864","DOIUrl":"https://doi.org/10.1016/j.ajogmf.2025.101864","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"8 2","pages":"101864"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146120611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1016/j.ajogmf.2025.101849
Laurie Beth Griffin, Marie Anderson, Christina Raker, Phinnara Has, Cindy-Lee Dennis, Adam K Lewkowitz
{"title":"A pilot randomized control trial assessing the acceptability and effect of in-hospital antenatal video breastfeeding education among nulliparous pregnant people.","authors":"Laurie Beth Griffin, Marie Anderson, Christina Raker, Phinnara Has, Cindy-Lee Dennis, Adam K Lewkowitz","doi":"10.1016/j.ajogmf.2025.101849","DOIUrl":"https://doi.org/10.1016/j.ajogmf.2025.101849","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"8 2","pages":"101849"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146120588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1016/j.ajogmf.2025.101848
Saule Issenova, Dilfuza Sultanmuratova
{"title":"Response to Letter to the Editor regarding Sequential use of Foley catheter and misoprostol vs misoprostol alone for induction of labor: a multicenter randomized controlled trial.","authors":"Saule Issenova, Dilfuza Sultanmuratova","doi":"10.1016/j.ajogmf.2025.101848","DOIUrl":"https://doi.org/10.1016/j.ajogmf.2025.101848","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"8 2","pages":"101848"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146120680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1016/j.ajogmf.2025.101861
Charlotte McCarley, Yumo Xue, Ashton Robinson, Chase Cawyer, Sara Gould, Ashley Battarbee
{"title":"The association between physical activity during pregnancy and perinatal depression.","authors":"Charlotte McCarley, Yumo Xue, Ashton Robinson, Chase Cawyer, Sara Gould, Ashley Battarbee","doi":"10.1016/j.ajogmf.2025.101861","DOIUrl":"https://doi.org/10.1016/j.ajogmf.2025.101861","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"8 2","pages":"101861"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146120782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1016/j.ajogmf.2025.101853
Moti Gulersen, Erez Lenchner, Ashley Battarbee, Hiba J Mustafa, Alireza A Shamshirsaz, Cynthia Gyamfi-Bannerman, Vincenzo Berghella, Eran Bornstein
{"title":"National trends in periviable antenatal corticosteroid administration and neonatal outcomes after implementation of a practice advisory.","authors":"Moti Gulersen, Erez Lenchner, Ashley Battarbee, Hiba J Mustafa, Alireza A Shamshirsaz, Cynthia Gyamfi-Bannerman, Vincenzo Berghella, Eran Bornstein","doi":"10.1016/j.ajogmf.2025.101853","DOIUrl":"https://doi.org/10.1016/j.ajogmf.2025.101853","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"8 2","pages":"101853"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146120674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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