Does maternal use of Selective Serotonin Reuptake Inhibitors (SSRIs) lead to fetal macrosomia?

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Last updated: May 26, 2025View editorial policy

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From the Research

Taking selective serotonin reuptake inhibitors (SSRIs) during pregnancy does not consistently lead to having a bigger baby, and in fact, may be associated with a small increased risk of lower birth weight or small-for-gestational-age babies, as suggested by studies such as 1 and 2. The decision to continue or start SSRI treatment during pregnancy should always be made in consultation with healthcare providers, weighing the benefits of treating maternal depression against potential risks. Some key points to consider include:

  • Untreated depression during pregnancy carries its own risks for both mother and baby, including poor prenatal care, inadequate nutrition, and increased risk of preterm birth, as noted in 3 and 4.
  • SSRIs work by increasing serotonin levels in the brain, which helps regulate mood, but these medications can cross the placenta and reach the developing fetus.
  • Common SSRIs include medications like fluoxetine (Prozac), sertraline (Zoloft), escitalopram (Lexapro), and citalopram (Celexa), which are prescribed at varying doses depending on individual needs.
  • If you're pregnant or planning pregnancy and taking an SSRI, don't stop your medication without consulting your doctor, as the risks of untreated depression may outweigh the potential risks of medication, as recommended in 1 and 5. It's essential to consider the most recent and highest-quality studies when making decisions about SSRI use during pregnancy, and the current evidence suggests that SSRIs can be considered as appropriate treatment for pregnant women with depression, while carefully weighing the potential risks and benefits, as stated in 1.

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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