Two Studies Look at Antidepressants and Pregnancy

As many as 1 in 10 women will go through depression at some point during pregnancy or after the birth of their baby. Although expectant mothers should avoid some medications whenever possible, stopping or avoiding depression treatment during pregnancy can come with its own serious risks.

Now, two separate but similar studies report that the overall risk for most types of birth defects is low when pregnant women take selective serotonin reuptake inhibitors (SSRIs) — the most common kind of antidepressant medication used to treat depression in the United States.

And although certain individual antidepressants may significantly increase the risk of specific birth defects, the two huge studies report that the actual increased risk for any of the individual serious defects is still very low (less than 1%).

Together, the studies looked at a combined 19,471 newborns with birth defects and 9,952 babies with no defects — far more cases than past studies — who were born to mothers who’d taken antidepressants in the months prior to conceiving or during the first trimester.

One study was conducted by the Centers for Disease Control and Prevention's (CDC) National Center on Birth Defects and Developmental Disabilities and the University of British Columbia. The other comes from Boston University, Massachusetts General Hospital for Children, and the Harvard School of Public Health.

The CDC study did find three defects that hadn't been previously associated with SSRI use during pregnancy — a defect of the brain, one type of abnormal skull development, and a gastrointestinal abnormality. The researchers say the increased risk was minimal, but the CDC plans to do more research on those particular defects.

What This Means to You

These latest studies are just two of the many that have been — and will continue to be — done on the possible links between antidepressant use during pregnancy and the risk of birth defects. And different studies may come to different conclusions.

For example, various previous studies have found that newborns of mothers who took certain SSRIs while pregnant may develop symptoms of withdrawal a few days after birth (such as shaking, gastrointestinal problems, sleeping disturbances, and high-pitched crying), persistent pulmonary hypertension (a serious lung condition), and/or heart defects.

But untreated depression can be hazardous for both the expectant mother and her baby. Why? For one, a depressed pregnant woman may be less able to take care of her baby during the pregnancy and after the birth. And some studies have shown that pregnant women who aren't treated for depression may be at risk for other health problems.

Another recent study showed that pregnant women who stopped taking their depression medication were five times more likely to have a relapse (to become depressed again) than those who kept taking their medicine throughout the pregnancy.

If you're pregnant and depressed, don't hesitate to get the help you need. Your doctor (or other health care provider) can help you carefully weigh the risks and benefits of individual medications and devise a treatment plan that’s specifically tailored to your situation, pregnancy, and medical history.

If you're trying to conceive or just found out you're expecting, talk to your doctor as soon as possible about all of the over-the-counter and prescription medications you’re taking to make sure they're safe to continue during your pregnancy. And don't stop taking any previously prescribed medications without talking to your doctor first.

Sources: "Use of Selective Serotonin-Reuptake Inhibitors in Pregnancy and the Risk of Birth Defects" and "First-Trimester Use of Selective Serotonin-Reuptake Inhibitors and the Risk of Birth Defects," New England Journal of Medicine, June 28, 2007.