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Date posted: November 2, 2012

This literature review was conducted to evaluate treatment of depression in pregnant women and to challenge the assumption that the risks of selective serotonin reuptake inhibitor (SSRI) use are lower than the risks of untreated mild and moderate depression during pregnancy.

The investigators found that antidepressant use during pregnancy is associated with increased risks of miscarriage, birth defects, preterm birth, newborn behavioral syndrome, persistent pulmonary hypertension of the newborn, and possible longer-term neurobehavioral effects, and there was no evidence of improved pregnancy outcomes with antidepressant use.

Pregnant women who took antidepressants were at risk for miscarriage and preterm delivery, and their babies were at risk for a number of developmental and health complications, researchers found.

A systematic review of studies looking at the effects of selective serotonin reuptake inhibitors (SSRIs) in pregnant women on infant outcomes showed a significant relationship between SSRI use and preterm birth (OR 1.46, 95% CI 1.31 to 1.63), persistent pulmonary hypertension of the newborn (OR 2.1, 95% CI 1.5 to 3.0), preeclampsia (OR 1.53, 95% CI 1.33 to 1.69), and long-term neurobehavioral effects, according to Alice Domar, PhD, of Beth Israel Deaconess Medical Center in Waltham, Mass., and colleagues.

SSRI use in women also was associated with a higher risk of miscarriage, birth defects, newborn behavioral syndrome, neonatal electrocardiograph changes, and fetal growth effects, they wrote online in Human Reproduction.

“A standard recommendation for women who report the need for medication to treat symptoms of depression during their pregnancy has been that the benefit of antidepressant use outweighs the risk of depression during the gestational and postpartum period,” Domar and colleagues said.[Source]

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