Am J Obstet Gynecol MFM

SSRI exposure in utero: A calculated trade off?

February 19, 2026

In a Finnish cohort of 1.27 million births, maternal SSRI use during pregnancy (≥2 purchases; N = 19,020) was associated with a modestly increased risk of gestational diabetes (odds ratio [OR], 1.14; adjusted OR, 1.20) and certain neonatal outcomes, including low 5‑minute Apgar scores (OR, 2.02; third‑trimester exposure OR, 3.44), breathing problems (OR, 1.61), and need for neonatal care unit treatment (OR, 1.23). At the same time, SSRI use was linked to lower risks of cesarean delivery, very preterm birth (<32 weeks), and low or very low birth weight compared with pregnant patients who had depression but were unmedicated. These findings highlight that underlying maternal depression carries significant obstetric risks and that many SSRI‑associated neonatal effects remain mild and transient.

Clinical takeaway: Guide SSRI decisions in pregnancy case‑by‑case, balancing their protection against preterm birth with generally mild, short‑lived neonatal adaptation effects, and recognizing that leaving maternal depression untreated carries significant risks for both mother and baby.

Source:

Malm H, et al. (2026, February 4). Am J Obstet Gynecol MFM. SSRI use during pregnancy and maternal depression - a nationwide birth cohort study on risks to the mother and the newborn. https://pubmed.ncbi.nlm.nih.gov/41651031/