Antidepressants While Pregnant: Inside the Benefits and Risks

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Can meds for depression or anxiety be dangerous for both mother and baby? A new study set out to get an answer. (Photo: iStock)

Up to 10 percent of women are prescribed a class of antidepressants called SSRIs (selective serotonin reuptake inhibitors) during pregnancy, typically because they’ve previously been diagnosed with depression or anxiety. But are these meds a threat to an unborn baby?

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It’s a question that doctors and moms to be have tried to get answered for years. While SSRIs are generally considered safe in pregnancy, some research has linked them to a higher rate of complications, such as preterm birth and low birth weight.

Now a new study has set out to answer the question, and the results are mixed. On one hand, researchers determined that treating an expectant mom’s depression or anxiety with SSRIs is actually associated with a lower risk of complications, such as preterm birth and delivery via cesarean section.

The downside, however, is that taking SSRIs during pregnancy caused an uptick in neonatal problems that required monitoring by doctors, like newborn breathing issues, according to the study, which was published online today in The American Journal of Psychiatry.

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“Taking antidepressants while pregnant poses a real clinical dilemma,” Alan Brown, MD, senior author of the study and professor of psychiatry and epidemiology at Columbia University, tells Yahoo Parenting.

“The study sought to determine if the risk to the baby is greater than the risk to a pregnant woman diagnosed with depression or another condition who goes off them,” says Brown.

The researchers examined data relating to 845,345 births in Finland from 1996 to 2010. They compared health outcomes of pregnant women diagnosed with depression or another mental health issue who took SSRIs to the outcomes for pregnant women with psychiatric diagnoses who didn’t take meds.

The most intriguing finding was that taking SSRIs during pregnancy was associated with fewer of the complications previous studies have found, such as preterm birth and a higher rate of C-sections. But the study also linked SSRIs to neonatal health issues. Besides breathing issues, these included a lower APGAR score after birth.

One explanation for the postbirth baby health problems: The newborns may have been in withdrawal from SSRIs. “Adults who go off SSRIs show signs of withdrawal as well,” says Brown. But the neonatal complications might also be a consequence of the toxicity of SSRIs, he says.

As for why SSRIs led to fewer pregnancy complications for moms, Brown says it could be that the medicine kept depression or anxiety under control for the pregnant women, and that lowered stress levels. “Depression is associated with stress and damaging health effects, like higher cortisol levels, which might be the cause of these complications,” he says.

So if you take SSRIs and are pregnant or thinking about conceiving, should you go off your meds? The takeaway of the study, says Brown, is to talk it over with your doctor and discuss the benefits and risks.

Ob-gyns who treat women on SSRIs agree. “It’s important to make an informed decision based on your own health history and the severity of your condition,” Alyssa Dweck, MD, an ob-gyn in Westchester, N.Y., and coauthor of V Is for Vagina, tells Yahoo Pregnancy.

“If it’s mild depression or anxiety and you can go off SSRIs, lower your dosage, or switch to another antidepressant not linked to these outcomes, it might be a good idea,” says Dweck. “But depression and anxiety are true diseases, and in many cases it may be worse for a woman to stop taking [the meds] than if she continued her prescription.”

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