Neonatal Outcomes Associated with Maternal SSRI Use throughout the COVID Pandemic

Authors

• Carlie G. Gatlin, Children's Mercy Kansas CityFollow
• Megan Tucker, Children's Mercy HospitalFollow
• Angela Bolton, Children's Mercy Kansas CityFollow
• Mary Anne Kucera, Children's Mercy Kansas CityFollow
• Deanna McPherson, Children's Mercy Kansas CityFollow
• Kerry Kohrs, Children's Mercy Kansas CityFollow
• Staci S. Elliott, Children's Mercy Kansas CityFollow
• Hung-Wen Yeh, Children's Mercy HospitalFollow
• Venkatesh Sampath, Children's Mercy HospitalFollow

Publication Date

4-2026

Files

Abstract

Background: Maternal antenatal selective serotonin reuptake inhibitor (SSRI) use has been suggested as a risk factor for neonatal complications, though evidence remains inconclusive. Mental health conditions increased during the COVID-19 pandemic, raising questions about SSRI prescription trends. This study examines associations between maternal SSRI use and neonatal outcomes across three time periods: before, during, and after the pandemic. Objectives: Primary: Determine if SSRI use in pregnancy is associated with NICU admission, respiratory support, hospital stay length, hypoglycemia, formula feeding, and/or delivery room resuscitation. Secondary: Assess SSRI prescription prevalence across pandemic phases. Methods: Retrospective chart review of term maternal-infant dyads born in Jan/June during each of the years of 2019–2022 in a level III NICU. Data included maternal demographics, SSRI use, comorbidities, and neonatal outcomes. Exclusions: congenital anomalies, multiple gestations, and preterm birth < 37 weeks. N=1,246. Categorical variables were compared using Chi-squared or Fisher’s exact test; continuous variables via Wilcoxon or Kruskal-Wallis tests. Regression models adjusted for COVID phase and covariates. Missing data (>5%) were imputed using MICE and random forest, with pooled results via Rubin’s rule. Results: Maternal SSRI use rates did not differ significantly across the 3 time periods (pre-Covid 54/572 9.5% vs. during Covid 31/338 9.3% vs. post-Covid 36/336 11%) (Table 1). SSRI use was highest among those with pre-pregnancy use (p=< 0.001), and white mothers (White 108/890 12% vs. Non-white 13/354 3.7 %, p= < 0.001) (Table 2). Infants exposed to SSRIs were more likely to require delivery room resuscitation (OR 2.51, 95% CI 1.19-5.26, p= 0.015) (Table 3B). Mothers using SSRIs were more likely to formula or combo feed rather than exclusively breastfeed (OR 2.86, 95% 1.68-4.85, p=0.000) (OR 1.91, 95% 1.05-3.47, p= 0.034) (Table 3F). No significant associations were found between maternal SSRI use and neonatal hypoglycemia, NICU admission, respiratory support, or length of stay (Table 3A,C,D,E). Conclusion: In our study, we did not find an increase in maternal SSRI use during the COVID pandemic. Maternal SSRI use was associated with increased delivery room resuscitation and non-exclusive breastfeeding, but not other adverse neonatal outcomes. These findings highlight the continued concerns of maternal SSRI use on neonatal outcomes, and advocate for careful consideration and discussion of its benefits vs. risks in pregnant mothers as expressed by recent FDA and ACOG statements.

Disciplines

COVID-19 | Maternal and Child Health | Pediatrics

Notes

Presented at the 2026 Pediatric Academic Societies (PAS) Annual Meeting; Boston, MA; April 24-27, 2026.

Recommended Citation

Gatlin, Carlie G.; Tucker, Megan; Bolton, Angela; Kucera, Mary Anne; McPherson, Deanna; Kohrs, Kerry; Elliott, Staci S.; Yeh, Hung-Wen; and Sampath, Venkatesh, "Neonatal Outcomes Associated with Maternal SSRI Use throughout the COVID Pandemic" (2026). Posters. 512.
https://scholarlyexchange.childrensmercy.org/posters/512