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Cohort study
Use of antidepressants in the second trimester is associated with reduced pregnancy duration, and third trimester antidepressant use with infant convulsions
  1. Jennifer L Payne
  1. Department of Psychiatry, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
  1. Correspondence to : Dr Jennifer L Payne
    Department of Psychiatry, Johns Hopkins School of Medicine, 550 N. Broadway, Suite 305, Baltimore, MD 21205, USA; jpayne5{at}

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Implications for practice and research

  • Second trimester exposure to antidepressants was associated with preterm birth.

  • Third trimester exposure was associated with infant convulsions.

  • The absolute risk for both outcomes is extremely low and most infants will not have these complications.

  • Decisions about whether to use antidepressants during pregnancy should include the severity of the mother's psychiatric illness.

  • Large studies that include severity of the mother's illness need to be conducted.


Approximately 10–20% of women will meet the criteria for major depressive disorder (MDD) during their lifetime, including during pregnancy.1 Rates of antidepressant exposure …

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  • Competing interests JLP has received expert testimony fees from Astra Zeneca and Pfizer, and has served on an Advisory Board for Pfizer.