Use of antidepressant medications has risen in Iceland over the past decade. Given the prevalence of treatment with selective serotonin reuptake inhibitors and serotonin–norepinephrine reuptake inhibitors (SSRI/SNRI) among pregnant women, the authors examined whether exposure at the time of delivery is associated with measurable differences in immediate neonatal outcomes. The stated aim was to determine the prevalence of maternal SSRI/SNRI use at delivery and to compare rates of neonatal resuscitation or support, monitoring or admission to the neonatal intensive care unit (NICU), and clinical signs potentially linked to drug exposure.
This retrospective comparative study included all infants born at Landspítali during 2023 (initial n = 3,200). Infants born before 35 weeks’ gestation were excluded from analysis; after exclusions the analytic cohort comprised 3,069 infants. The study group comprised infants whose mothers were on SSRI/SNRI treatment at the time of delivery. The control group included all other infants in the study population. Infants admitted to the NICU were examined in greater detail. The abstract does not report agent-level information (specific SSRI or SNRI), dosing, timing of last maternal dose before delivery, or maternal clinical indications beyond antidepressant use.
Among the 3,069 infants analyzed, 336 (10.9%) were exposed to maternal SSRI/SNRI therapy during pregnancy and at delivery. The need for immediate neonatal support (defined in the abstract as neonatal support or resuscitation) was significantly higher in the exposed group: 29.2% of exposed infants required support versus 14.6% in the control group.
Admission to or monitoring in the NICU was also more common in the SSRI/SNRI group (19.4%) compared with controls (13%). Additional statistically significant differences reported in the abstract included higher rates of respiratory distress, lower Apgar scores at both 1 and 5 minutes, and a higher frequency of sepsis work-ups among exposed infants.
The abstract highlights several specific neonatal findings associated with maternal SSRI/SNRI treatment at delivery:
Respiratory distress was more frequently observed in infants exposed to SSRI/SNRI compared with unexposed infants. The abstract does not provide absolute counts for each respiratory diagnosis nor detail on oxygen requirements or duration of respiratory support beyond the increased need for postnatal respiratory assistance.
Apgar scores at 1 and 5 minutes were lower in the exposed group. The abstract does not include mean Apgar values, ranges, or distribution, only that the difference was significant.
Exposed infants underwent sepsis work-ups more often than controls. The abstract does not report confirmed infection rates, culture results, biomarkers, or antibiotic usage.
NICU admission or monitoring was increased among exposed neonates (19.4% vs. 13%), and overall need for neonatal support (including oxygen therapy and respiratory assistance) was higher (29.2% vs. 14.6%). Details on length of NICU stay, interventions performed in NICU, or short-term outcomes after NICU care were not provided in the abstract.
In this single-center retrospective cohort from Iceland, maternal SSRI/SNRI treatment at the time of delivery was associated with an increased likelihood that newborns would require immediate postnatal support, including oxygen and respiratory assistance, as well as increased rates of NICU monitoring or admission. Exposed infants had lower Apgar scores at birth and more frequent sepsis evaluations.
These findings suggest that infants born to mothers on SSRI/SNRI therapy may need heightened surveillance in the delivery room and early neonatal period. Clinicians planning peripartum care may consider the increased probability of respiratory support and NICU involvement when counseling pregnant patients on antidepressant treatment and when preparing delivery-room staffing and monitoring strategies.
The published abstract does not report several details that would inform interpretation and clinical application:
Because these items were not reported in the abstract, readers should consult the full text for additional methodological detail and to assess potential confounding factors. The abstract presents a clear association between maternal SSRI/SNRI use at delivery and increased immediate neonatal care needs, but causal inference and implications for individual treatment decisions require consideration of maternal mental health status and full clinical context.