Reply to Dr Kawada: Late-Gestation Selective Serotonin Reuptake Inhibitor Exposure and Perinatal Mortality

We appreciate the interest by Dr Kawada1 in our study investigating neonatal outcomes after late-gestation exposure to selective serotonin reuptake inhibitors (SSRIs)2 and the call for additional analyses to examine clinical manifestations of the infants, in particular, fatal outcomes. Given the rarity of fatal outcomes, such as stillbirth (3.69 per 1000) and neonatal death (2.20 per 1000) as reported by Stephansson et al,3 our associated sample size was not sufficient to enable adequate statistical power to justify their investigation. We do, however, appreciate the significance of including data on infant mortality to more completely describe the effects of prenatal SSRI exposure on extreme clinical manifestations and the infant life prognosis. In accordance with this, we have included data on stillbirths and neonatal death later.