Duloxetine is a selective serotonin-norepinephrine reuptake inhibitor (SNRI) used to treat major depressive disorders in adults. It is advised for pregnant women only when clearly needed, but its effects on the mother and fetus are unclear. This study aims to assess the maternal and fetus outcomes following exposure to duloxetine during pregnancy.

This is a cohort study conducted on pregnant women of 18 to 55 years of age and their liveborn infants. The participants were divided into two groups. One group had mothers and their infants who were exposed to duloxetine during pregnancy, and the other group had mothers and infants with no exposure to duloxetine and other SNRIs. The primary outcome of the study was congenital and cardiovascular malformations, preterm birth, pre-eclampsia, postpartum hemorrhage, and small for gestational age infant.

The base risk per 1000 unexposed women for mothers and infants exposed to duloxetine was 36.6 for congenital malformations, 107.8 for CVD malformations, 20.4 for preterm birth, 23.3 for postpartum hemorrhage, 20.4 for preterm birth, 33.3 from pre-eclampsia, and 20.4 for small for gestational age. The relative risk for all aforementioned conditions was between 1.0 and 1.6.

The research concluded that exposure to duloxetine was unlikely to cause major complications, but it might be associated with an increased risk of postpartum hemorrhage and cardiovascular malformations.

Ref: https://www.bmj.com/content/368/bmj.m237