Geen effect SSRI of SNRI op prevalentie van hyponatriemie tijdens de zwangerschap: een retrospectief cohortstudie

Background During pregnancy, sodium levels in the blood decrease, due to a physiological hypervolemic state. Hyponatremia is a known and rare side effect of selective serotonin reuptake inhibitor (SSRI) and serotonin and norepinephrine reuptake inhibitor (SNRI) use. Due to a lack of literature regarding this subject, it vjas hypothesized that the usage of SSRI or SNRI during pregnancy v\/ould increase the risk of hyponatremia. Objective To assess the prevalence of hyponatremia during pregnancy wîth patients using SSRI or SNRI versus a control group using benzodiazepines. Design Retrospective cohort study Methods During the period from 01-11-2017 to 01-01-2022 medical records were searched in two Dutch hospitals. Data regarding the prevalence of hyponatremia in women who used SSRI or SNRI during pregnancy (index group) versus a control group of pregnant women who used benzodiazepines during pregnancy were collected. Results Among 154 pregnant women who used an SSRI or SNRI with at least one or more serum sodium concentrations were determined. No cases of hyponatremia were seen in the index group. In the 448 pregnant women in the control group, sodium concentrations were determined 486 times during pregnancy in which one case of hyponatremia was observed. Given the low number of events (hyponatremia) in both index and control group, it was not possible to perform a multivariate analysis with effect modifiers. Conclusion The hypothesis was that the usage of SSRI or SNRI during pregnancy would cause greater risk of hyponatremia. No hyponatremia occurred in our index group. This suggests that the combination of SSRI or SNRI use during pregnancy are not associated with an increased risk of hyponatremia.