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Use of antidepressants during pregnancy has been associated with a low
Apgar score in infants but a contribution from the underlying depressive
disorder might influence this association.
To estimate the effects of maternal depression and use of antidepressants
during pregnancy on low Apgar scores (<7) 5min after birth.
Register study on all pregnant women in Denmark from 1996 to 2006 linking
nationwide individualised data from the Medical Birth Register, the
Psychiatric Central Register and the National Prescription database.
Infants exposed to antidepressants during pregnancy had an increased rate
of a low Apgar score (odds ratio (OR) = 1.72, 95% CI 1.34-2.20). The
increased rate was only found among infants exposed to selective
serotonin reuptake inhibitors (SSRIS) (OR =1.96, 95% CI 1.52-2.54), not
among those exposed to newer (OR = 0.83, 95% CI 0.40-1.74) or older
antidepressants (OR=0.53, 95% CI 0.19-1.45). Maternal depression before
or during pregnancy, without prescription of antidepressants, was not
associated with a low Apgar score (OR=0.44, 95% CI 0.11-1.74). Women who
had only used antidepressants prior to pregnancy had no increased rate of
a low Apgar score in their subsequent pregnancy, regardless of depression
Use of SSRls during pregnancy increases the risk of a low Apgar score
independently of maternal depression.
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