SSRIs pose new risk during pregnancy: Longer umbilical cords

By John Murphy, MDLinx
Published May 9, 2016

Key Takeaways

Women who used selective serotonin reuptake inhibitors (SSRIs) during pregnancy were more likely to give birth to newborns with longer umbilical cords, according to a study published April 29, 2016 in the journal PLoS ONE. A longer umbilical cord may reduce fetal circulation, wrap around the fetus’s neck, or cause problems in later pregnancy and labor, the researchers noted.

Previous research has found an association between mothers’ use of SSRI antidepressants and lower Apgar scores and birthweight of newborns, but this is the first study to find an association with SSRIs and umbilical cord length.

SSRIs may increase the activity and movements of the developing fetus, the researchers noted.

“When the fetus moves, the umbilical cord stretches and eventually gets longer,” said the study’s first author Julia Kivistö, PhD student in the Department of Psychiatry at the University of Eastern Finland, in Kuopio, Finland.

For this study, the researchers reviewed data on all women who gave birth between 2002 and 2012 at Kuopio University Hospital in Finland. Of these women, 369 used SSRIs. After adjusting for confounding factors, the researchers found that the infants with the longest umbilical cord lengths were more than 1.6 times as likely to have been exposed to prenatal SSRIs. The researchers found that this effect was most associated with the SSRIs fluoxetine, citalopram, and paroxetine.

In addition, newborns exposed to SSRIs had significantly lower Apgar scores and more admissions to the neonatal intensive care unit than newborns not exposed to SSRIs.

SSRI use during pregnancy has substantially increased in the past several years, the researchers noted.

“Depression, both when left untreated and when treated with drugs, causes some changes to the course of pregnancy and birth. This is why it is extremely important to carefully consider the individual situation of each patient when choosing the treatment,” Ms. Kivistö said.

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