Huybrechts KF, et al. - In order to find out the risk of adverse maternal and infant outcomes following in utero exposure to duloxetine, a cohort study nested in the Medicaid analytic extract including pregnant women 18 to 55 years of age and their liveborn infants between 2004 and 13 was conducted. The main outcome measures were congenital malformations overall, cardiac malformations, preterm birth, small for gestational age infant, pre-eclampsia, and postpartum hemorrhage. The duloxetine is unlikely to be a major teratogen but may be correlated with an increased risk of postpartum hemorrhage and a small increased risk of cardiac malformations on the basis of the evidence available to date. These potential small increases in the risk of relatively uncommon outcomes must be weighed against the benefits of treating depression and pain during pregnancy in a given individual, while continuing to monitor the safety of duloxetine as data accumulate over time, t.