New Results on Antidepressants in Pregnancy
A series of three recent studies into the side-effects of antidepressant use during pregnancy has found no clear effects on the baby but a possible risk of hemorrhage during childbirth.
Depression is common in pregnancy and afterwards, with a rate of 11% to 20% in the United States. Antidepressants are being increasingly used, so a large body of research has examined the potential risks.
The first study, led by Dr. Marte Handal of the Norwegian Institute of Public Health, included details on 51,404 children. Among the mothers, 159 used selective serotonin reuptake inhibitors (SSRIs) during pregnancy.
At three years old, the children in this group showed “a slight delay in the development of fine and gross motor skills,” but the study is limited by small the numbers. Dr. Handal, stated, “Our results show that treatment with SSRIs during longer time periods in pregnancy was weakly associated with a delayed motor development at age three. However, only a very small number of children had a severe delay. Even though we did take into account maternal symptoms of depression we still did not have complete information on the severity of the maternal depression in the different groups.
“Effective treatment of depression during pregnancy is essential and these results should not discourage healthcare professionals from prescribing or continuing antidepressant treatment to those who need it.”
In the second study, information from 49,000 women in Australia was analyzed. This indicated that, while untreated prenatal depression in the mother was linked to an increased risk of problem behavior in the children (hyperactivity, inattention, and peer problems) at age seven, there was no raised risk when the mother took antidepressants.
The last study was carried out by the same team. Dr. Luke Grzeskowiak and colleagues at The University of Adelaide, Australia, analyzed figures on 29,850 women. This showed the rate of postpartum hemorrhage (loss of 500 to 1,000ml of blood in the first 24 hours) was 16% if the woman had taken antidepressants in the last trimester, compared with 11% if she had not.
“It is reassuring to find that prenatal exposure to antidepressants did not affect a child’s behavior at age seven, however as with any medication, the benefits and risks must always be considered,” Dr. Grzeskowiak said. “Regarding our other study, overall the risks for postpartum hemorrhage are largely unknown. We found separate increases in risk with placenta praevia, prolonged labor, hypertension and assisted vaginal delivery, as well as the increased risk seen with antidepressant use. However we did not have data on known risks such as use of oxytocin during delivery, nor did we have any data on the severity of the underlying maternal psychiatric illness.