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The use of antidepressants during pregnancy is not linked to a higher overall risk of stillbirth and death in newborns, a study said on Tuesday, confounding a long-held opposing view of such drugs.

The Swedish study of more than 1.6 million births in five Nordic countries included nearly 30,000 women who had filled in a prescription for an SSRI (selective serotonin reuptake inhibitor) during pregnancy.

The researchers found that the 1.79 per cent of mothers exposed to an SSRI had higher rates of stillbirth (4.62 versus 3.69 per 1,000) and postneonatal death (1.38 versus 0.96 per 1,000) than those who did not.

But the slightly higher rates were attributed to the severity of the underlying psychiatric disease – usually depression – rather than its treatment.

This study looked at information on dispensed drugs, not ingested drugs, and these numbers are often quite different

Cigarette smoking and the mother’s advanced age were also linked to higher deaths.

Among the total surveyed group there were 1,633,877 single births, 6,054 stillbirths, 3,609 neonatal deaths and 1,578 postneonatal deaths.

The study “suggests that SSRI use during pregnancy was not associated with increased risks of stillbirth, neonatal death or postneonatal death,” said authors of the research led by Olof Stephansson of the Karolinska Institutet in Stockholm.

“However, decisions regarding use of SSRIs during pregnancy must take into account with other perinatal outcomes and risks associated with maternal mental illness,” they said.

But a US-based expert expressed concern at the findings, published in yesterday’s edition of The Journal of the American Medical Association.

“This study looked at information on dispensed drugs, not ingested drugs, and these numbers are often quite different,” Adam Urato, assistant professor of obstetrics and gynaecology at Tufts University School of Medicine, told WebMD Medical News.

“I don’t find the study results particularly reassuring,” he said.

The women included in the study were from Denmark, Finland, Iceland, Norway and Sweden. The data covered different periods from 1996 to 2007.

Researchers obtained inform-ation on the use of antidepressants from prescription registries, while patient and medical birth registries provided the data for maternal characteristics, pregnancy and neonatal outcomes.

Between seven and 19 per cent of women suffer from depression during pregnancy, according to background information in the study.

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