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 Clinical Implications: 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 GI Bleeding
Clinical Implications: Although flawed, pathophysiology and studies combine for reasonable mechanism. Likely should be avoided if possible. PPI Therapy:
CVA Risks:
Clinical Implications:
Summary:
Do we need to consider bleeding risk when prescribing SSRIs?
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