Harvard Mental Health Letter

In Brief: SSRIs and risk of postpartum hemorrhage

In Brief

SSRIs and risk of postpartum hemorrhage

Several studies have concluded that selective serotonin reuptake inhibitors (SSRIs) substantially increase the risk of gastrointestinal bleeding. University of Toronto researchers decided to investigate whether these drugs also increase the risk of postpartum hemorrhage, a potentially life-threatening complication that occurs in about 4% of vaginal deliveries and 6% of cesarean section deliveries.

About 2.8% of pregnant women in a large U.S. sample, and almost 1% of pregnant women in two European samples, took antidepressants. It is not clear how many of these women were taking SSRIs.

The Toronto researchers used Canadian medical records to identify 2,460 women who had experienced postpartum hemorrhage between January 1999 and March 2005. The researchers next identified 23,943 controls, matched by age, mode of delivery, and other characteristics. The investigators then used prescription records to determine how many of the women had been taking any type of antidepressant in the 90 days before delivery — a time frame chosen to focus on the last trimester of pregnancy.

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