A depressing pregnancy conundrum

Related articles

Women taking antidepressants who become pregnant are faced with a difficult choice: Should they continue their treatment, which may pose risks to the unborn child, or should they stop taking the medication and risk their own mental health, as well as the health of their newborn?

Many studies have attempted to answer that question, and new results suggest that, for some depressed pregnant women, the safest course may be a trial of stopping their antidepressants. Research published in the American Journal of Obstetrics & Gynecology seems to support this conclusion, based on an analysis of nearly 230,000 Tennessee women who gave birth between 1995 and 2007. Researchers from Vanderbilt University s School of Medicine found that, for each prescription a woman filled for antidepressants during her second trimester, her odds of early labor doubled. Patients who filled two or three prescriptions had babies that were born, on average, four to five days sooner than babies born to mothers not taking antidepressants.

In addition, the most widely used class of antidepressants, known as SSRIs (e.g. Prozac or Zoloft), when taken during the third trimester, led to a five-fold increase in the risk of seizure in the newborns. The authors note, however, that the absolute risk is still very small seizures were seen in only 0.2 percent (one in 500) of the infants studied, and such seizures are rarely associated with serious consequences.

Thus, although the results merit consideration, they don t provide clear evidence that antidepressants are a direct cause of either early delivery or seizures among newborns. As lead author Dr. Richard C. Shelton points out, many other factors involved when women use the drugs during pregnancy, such as the depression itself, may play a contributing role.

Before making any adjustments to treatment, however, women who are pregnant or who plan to become pregnant should talk to their doctors. As ACSH's Dr. Gilbert Ross notes, Stopping antidepressant therapy during pregnancy is also a risk factor for the neonate, and women who have been diagnosed as depressive are at a higher risk of postpartum depression which is not something to be taken lightly. Thus a conversation with your physician about all of the risks and benefits of taking antidepressants during pregnancy is a must.