Table 2.

Potential Risks of Gestational Use of Antidepressants

Outcome	Class of antidepressants	Magnitude of risk	RCT Study Design	Comparator Group of pregnant individuals with clinical indication for antidepressant use	Statistical Adjustment for other potential confounds
Congenital malformations	SSRIs	Relative risk ∼ 1.1⁷⁵	X	X	X
Congenital cardiovascular malformations	SSRIs	Relative risk ∼ 1.2 to 1.3^75,76	X	X	X
Spontaneous abortion	–	Relative risk ∼ 1.5⁹¹	X	X	X
Stillbirth	–	Relative risk ∼ 1.2⁹¹	X	X	X
Pre-eclampsia	SSRIs	Relative risk ∼ 1.4⁹²	X	X	X
Mean gestational age at birth	SSRIs	Mean difference: −0.36 weeks⁹⁴ (3 days earlier)	X	✓	X
Mean 5-minute APGAR score	SSRIs	Mean difference: −0.32⁹⁴ (APGAR score of 0.3 less)	X	✓	X
Low birthweight	–	Relative risk ∼ 1.4⁹¹	X	✓	X
Preterm birth	SSRIs	Relative risk ∼ 1.6¹²	X	✓	✓ (Race/ethnicity, parity and gestational tobacco use)
Postpartum hemorrhage	SSRIs	Relative risk ∼ 1.2⁹⁵	X	X	X
Persistent pulmonary hypertension of newborn	SSRI or SNRIs	Relative risk ∼ 1.5 to 1.8^99,100	X	X	X

Abbreviations: SSRIs, Selective serotonin reuptake inhibitors; SNRIs, Serotonin norepinephrine reuptake inhibitors; RCTs, Randomized controlled trials; Relative risk, risk ratio and/or odds ratio.
Notes: Risk refers to risk ratio or odds ratios from studies included in this review; Superscripts indicate citations describing the magnitude of the relative risk; A relative risk of two-fold or more (Risk ≥2.0) is generally accepted as being clinically significant at the level of an individual patient.³⁶ The Symbol “X” refers to “No” and the symbol “✓” refers to “Yes”.