Antidepressants and pregnancy
Treatment for depression is necessary for some pregnant women, but is it safe for the foetus? Over one per cent of pregnant women in the Norwegian Mother and Child Cohort Study (MoBa) used medication for depression during pregnancy. A sub-study shows no increased risk of congenital birth defects, premature birth or low birth weight after antidepressant use.
Almost 700 of over 63,000 participants in MoBa used medication for depression during pregnancy. Just over 1,000 women used antidepressants in the six months before conception but stopped when they became pregnant. Overall, there was no increase in birth defects, low birth weight or premature birth following the use of antidepressants. Several types of antidepressants were used, but selective serotonin reuptake inhibitors (SSRI) were most common. None of the individual medicines appeared to increase the risk of adverse events in pregnancy. The timeframe when the medicines were used had no significance.
Pregnant women, doctors and pharmacists must be careful with medicine use in pregnancy because any adverse events could also affect the vulnerable foetus. Medicines with particularly adverse effects in pregnancy exist, while we know little about the safety of new ones. Many new medicines are used to treat depression and anxiety, and therefore information on their safety in pregnancy is required. Previous studies have raised concerns that the risk of congenital heart defects may be increased by the use of certain antidepressants.
“As with all medicines, it is important to be cautious and have a good reason to prescribe antidepressants to pregnant women,” says Hedvig Nordeng and Malin Eberhard-Gran, who are researchers in the sub-study. “We found no increased risk of adverse events within the period and the end points we have studied. Depression in pregnant women can also have negative consequences for the child’s health. The risk and benefits for the mother's health during pregnancy should always be evaluated in each case. We believe that this study may contribute to a better knowledge base for such decisions, but these findings will reassure the pregnant women who need to use medicines in pregnancy” add the researchers.
Nordeng H, van Gelder MM, Spigset O, Koren G, Einarson A, Eberhard-Gran M. Pregnancy Outcome After Exposure to Antidepressants and the Role of Maternal Depression: Results From the Norwegian Mother and Child Cohort Study. J Clin Psychopharmacol. 2012 Apr;32(2):186-194.