Does taking fluoxetine increase the chance of miscarriage?
Miscarriage is common and can occur in any pregnancy for many different reasons. A small number of studies did not find a greater chance of miscarriage when fluoxetine was used in pregnancy.
Does taking fluoxetine increase the chance of birth defects?
Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. We look at research studies to try to understand if an exposure, like fluoxetine, might increase the chance of birth defects in a pregnancy.
Some studies have suggested an increased chance of heart defects or other birth defects with fluoxetine use. However, most studies have not found an increased chance of birth defects with fluoxetine use, and there is no proven increased chance of birth defects directly related to fluoxetine.
There are reports of more than 10,000 pregnancies exposed to fluoxetine during the first trimester, when many major birth defects can happen. No pattern of birth defects has been found. Overall, fluoxetine use is not expected to increase the chance of birth defects.
Does taking fluoxetine in pregnancy increase the chance of other pregnancy-related problems?
Some studies suggest a higher chance of preterm delivery (birth before week 37) or low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth) with the use of fluoxetine in pregnancy. However, research has also shown that when conditions such as depression or anxiety are untreated or undertreated during pregnancy, there could be an increased chance of pregnancy complications. This makes it hard to know if it is the medication, the underlying condition, or other factors that might increase the chance for these problems.
Some, but not all, studies have suggested that when SSRIs are taken during the second half of pregnancy, babies might have an increased chance for a serious lung condition called persistent pulmonary hypertension in newborns (PPHN). PPHN happens in 1 or 2 out of 1,000 births. A recent report combining the results of several studies suggested that the chance of PPHN might be higher with SSRI use during pregnancy. However, it is not clear if this is due to the medication or other factors that are more common among people who take SSRIs, such as smoking. Overall, the chance of PPHN when an SSRI is used during pregnancy is less than 1/100 (less than 1%).
I need to take fluoxetine throughout my entire pregnancy. Will it cause withdrawal symptoms in my baby after birth?
The use of fluoxetine during pregnancy and/or in the third trimester can cause temporary symptoms in newborns soon after birth. These symptoms are sometimes referred to as withdrawal. Symptoms include being irritable and/or jittery, crying, tight muscles, trouble breathing, unusual sleep patterns, tremors (shivers), and/or trouble eating. In most cases symptoms are mild and go away in a few weeks with no treatment, or with only supportive care. Not all babies exposed to fluoxetine will have these symptoms. There might be a higher chance for withdrawal symptoms if other psychiatric medications are also taken with fluoxetine during pregnancy. It is important that your healthcare professionals know you are taking fluoxetine so that if symptoms occur your baby can get the care that is best for them.
Does taking fluoxetine in pregnancy affect future behavior or learning for the child?
A few studies have looked at the development from 16 months to 7 years of age and found no differences between children who were exposed to fluoxetine during pregnancy and those who were not. Most studies have not found an increased chance of attention-deficit/hyperactivity disorder (ADHD) in children exposed to SSRIs, such as fluoxetine, during pregnancy. Most studies also have not found an increased chance of autism spectrum disorders (ASD) after adjusting for other factors such as the illness of the mother or the birthing parent.
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