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2007 – Medication, not maternal depression, linked to poor neonatal outcomes

Posted in SSRI Birth Defects

In 2007, a team of medical researchers from UCLA published a study titled “Effects of antenatal depression and antidepressant treatment on gestational age at birth and risk of preterm birth.” in The American Journal of Psychiatry that “evaluated the effects of prenatal antidepressant exposure and maternal depression on infant gestational age at birth and risk of preterm birth.”  The work of this team, led by R. Suri, marks an important step in coming to a complete understanding of the scope of adverse effects related to prenatal antidepressant exposure.  (In recent years, dozens of studies have demonstrated that neonatal withdrawal syndrome, cardiovascular birth defects, craniofacial birth defects, and other poor birth outcomes are linked to gestational exposure to SSRI drugs, for example.)

In this study, “Ninety women were followed … through pregnancy with monthly assessments of symptoms of depression and anxiety”, including “49 women with major depressive disorder who were treated with antidepressants during pregnancy (group 1), 22 women with major depressive disorder who were either not treated with antidepressants or had limited exposure to them during pregnancy (group 2), and 19 healthy comparison subjects (group 3).”

Results showed that “Groups 1, 2, and 3 differed significantly in gestational age at birth (38.5 weeks, 39.4 weeks, 39.7 weeks, respectively), rates of preterm birth (14.3%, 0%, 5.3%, respectively), and rates of admission to the special care nursery (21%, 9%, 0%, respectively). Birth weight and Apgar scores did not differ significantly between groups. Mild to moderate depression during pregnancy did not affect outcome measures.”

To be clear, Apgar score is a measure of how adequately a neonate adapts to life outside the womb.  MedlinePlus, a medical encyclopedia curated by the US National Library of Medicine explains the Apgar scoring system as follows:

“APGAR is a quick test performed on a baby at 1 and 5 minutes after birth. The 1-minute score determines how well the baby tolerated the birthing process. The 5-minute score tells the doctor how well the baby is doing outside the mother’s womb.

The APGAR test is done by a doctor, midwife, or nurse. The health care provider will examine the baby’s:

  • Breathing effort

  • Heart rate

  • Muscle tone

  • Reflexes

  • Skin color

Each category is scored with 0, 1, or 2, depending on the observed condition.

  • Breathing effort:

    • If the infant is not breathing, the respiratory score is 0.

    • If the respirations are slow or irregular, the infant scores 1 for respiratory effort.

    • If the infant cries well, the respiratory score is 2.

  • Heart rate is evaluated by stethoscope. This is the most important assessment:

    • If there is no heartbeat, the infant scores 0 for heart rate.

    • If heart rate is less than 100 beats per minute, the infant scores 1 for heart rate.

    • If heart rate is greater than 100 beats per minute, the infant scores 2 for heart rate.

  • Muscle tone:

    • If muscles are loose and floppy, the infant scores 0 for muscle tone.

    • If there is some muscle tone, the infant scores 1.

    • If there is active motion, the infant scores 2 for muscle tone.

  • Grimace response or reflex irritability is a term describing response to stimulation such as a mild pinch:

    • If there is no reaction, the infant scores 0 for reflex irritability.

    • If there is grimacing, the infant scores 1 for reflex irritability.

    • If there is grimacing and a cough, sneeze, or vigorous cry, the infant scores 2 for reflex irritability.

  • Skin color:

    • If the skin color is pale blue, the infant scores 0 for color.

    • If the body is pink and the extremities are blue, the infant scores 1 for color.

    • If the entire body is pink, the infant scores 2 for color.

The APGAR rating is based on a total score of 1 to 10. The higher the score, the better the baby is doing after birth.

A score of 7, 8, or 9 is normal and is a sign that the newborn is in good health. A score of 10 is very unusual, since almost all newborns lose 1 point for blue hands and feet, which is normal for after birth.

Any score lower than 7 is a sign that the baby needs medical attention. The lower the score, the more help the baby needs to adjusting outside the mother’s womb.

Most of the time a low Apgar score is caused by:

  • Difficult birth

  • C-section

  • Fluid in the baby’s airway

If your child has a low Apgar score, he or she may receive:

  • Oxygen and clearing out the airway to help the baby breathe

  • Physical stimulation to get the heart beating at a healthy rate

Most of the time, a low score at 1 minute is near-normal by 5 minutes.

A lower Apgar score does not mean a child will have serious or long-term health problem. The Apgar score is not designed to predict the future health of the child.”

Accordingly, the team concluded that “Prenatal antidepressant use was associated with lower gestational age at birth and an increased risk of preterm birth. Presence of depressive symptoms was not associated with this risk. These results suggest that medication status, rather than depression, is a predictor of gestational age at birth.” (emphasis added)

SSRI Birth Defect Lawsuits

If you or a loved one used SSRIs and gave birth to a child with a congenital malformation or who had perinatal complications, you may be entitled to significant financial compensation.  For a free, no-obligation case consultation, contact our team of SSRI birth defect lawyers at the information provided below.  We have the experience, resources, and skills required to win the justice you deserve.  Call today and see how we can help.

(855) 452 – 5529


Our SSRI Birth Defects Lawsuit Information page is a great place to start if you have any questions about SSRIs and Birth Defects.