Bleeding in Pregnancy:
SSRI use 1-2% of all pregnant females
Large Swedish study looking at pregnancy registry, unblinded
n = 500 with SSRI use, 39,000 controls
2.6/2.1 OR elevated risk for PPH/PP anemia
484 mL mean blood loss with SSRI vs 398 mL without SSRI
No overwhelmingly convincing evidence available as of yet
Given bleeding state of pregnancy as well as predilection of SSRIs for bleeding, risk/benefits should be weighed
Although flawed, pathophysiology and studies combine for reasonable mechanism. Likely should be avoided if possible.
Do we need to consider bleeding risk when prescribing SSRIs?
EM Rotators on Toxicology
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