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Antidepressants During Pregnancy Tied to Preterm Birth

Antidepressants During Pregnancy Tied to Preterm BirthA new systematic review of published literature discovers use of antidepressant medications during pregnancy can increase the risk of preterm birth.

This finding solidifies the recommendation to avoid antidepressants during pregnancy unless a person’s needs cannot be met through alternative approaches (such as psychotherapy), say the researchers.

“Preterm birth is a major clinical problem throughout the world and rates have been increasing over the past two decades. At the same time, rates of antidepressant use during pregnancy have increased approximately four-fold,” said lead author Krista Huybrechts, M.S., Ph.D.

“Therefore it is essential to determine what effects these medications have on pregnancy.”

Huybrechts and colleagues conducted a systematic review and meta-analysis of published studies that evaluated women who took antidepressants during pregnancy and had information on gestational age at birth.

The study results have been published online in the journal PLOS ONE.

“We studied 41 papers on this topic and found that the available scientific evidence is becoming clearer that antidepressant use in pregnancy is associated with preterm birth,” said senior author Adam Urato, M.D., a Maternal-Fetal Medicine specialist at Tufts Medical Center and MetroWest Medical Center.

“The complication of preterm birth did not appear to be due to the maternal depression, but rather it appears likely to be a medication effect.”

“Several of the studies in this review controlled for maternal depression and these studies continued to show increased rates of preterm birth in the antidepressant exposed pregnancies,” said Reesha Shah Sanghani M.D., M.P.H., from Vanderbilt University.

“It is important to keep in mind, however, that the issue of treatment of depression during pregnancy is complex and that there are many factors to consider. Pregnant women and their providers need to weigh many issues,” said Urato. “It is crucial, though, that the public gets accurate information on this topic.”

Rates of preterm birth have been increasing over the past two decades and it is a major public health concern.

Children born preterm have higher infant mortality rates than full-term babies and surviving infants are at increased risk of health problems ranging from neurodevelopmental disabilities such as cerebral palsy and intellectual delays to other chronic health problems like asthma. Costs to society have been estimated to be as high as $26.2 billion per year in the US.

Of the 41 studies which the authors reviewed, the majority showed increased rates of preterm birth in patients taking antidepressants. The association was strongest with use in the third trimester. There was no evidence of a beneficial effect or reduction in preterm birth with antidepressant use.

“Preterm birth is the leading cause of infant death and it is also a major contributor to both short and long-term illness,” said Urato. “While very preterm infants have the highest risk, we now know that even later preterm birth is associated with significant increases in neonatal morbidity and mortality.”

“Pregnant women with depression need proper treatment and our results should not be seen as an argument to ignore depression in these patients,” said Huybrechts.

“These drugs may be necessary in some pregnant women with severe depression in whom other approaches are inadequate. However, for many others, non-drug treatments, such as psychotherapy, will help, and aren’t associated with complications like preterm birth.”

Source: Tufts Medical Center

Antidepressants During Pregnancy Tied to Preterm Birth

Rick Nauert PhD

Rick Nauert, PhDDr. Rick Nauert has over 25 years experience in clinical, administrative and academic healthcare. He is currently an associate professor for Rocky Mountain University of Health Professionals doctoral program in health promotion and wellness. Dr. Nauert began his career as a clinical physical therapist and served as a regional manager for a publicly traded multidisciplinary rehabilitation agency for 12 years. He has masters degrees in health-fitness management and healthcare administration and a doctoral degree from The University of Texas at Austin focused on health care informatics, health administration, health education and health policy. His research efforts included the area of telehealth with a specialty in disease management.

APA Reference
Nauert PhD, R. (2015). Antidepressants During Pregnancy Tied to Preterm Birth. Psych Central. Retrieved on August 15, 2018, from https://psychcentral.com/news/2014/03/28/antidepressants-during-pregnancy-tied-to-preterm-birth/67751.html

 

Scientifically Reviewed
Last updated: 6 Oct 2015
Last reviewed: By John M. Grohol, Psy.D. on 6 Oct 2015
Published on PsychCentral.com. All rights reserved.