Antidepressants During Pregnancy: Safe?
Antidepressants During Pregnancy: Study Details continued...
Women registered with an SSRI prescription had higher stillbirth rates -- 4.62 for every 1,000, compared to 3.69 per 1,000 for women who were not on the drugs.
Women registered with an SSRI prescription also had a higher risk of their infants dying at ages 28 days to just under a year.
The rates of early newborn death were similar between groups.
Next, the researchers took into account factors that could have played a role in stillbirths or infant deaths. These included the mother's age, cigarette smoking, and the severity of the mother's psychiatric disease.
When they took those risk factors into account, they found no substantial link between the antidepressant use and risks of stillbirth or death.
Even so, the researchers say women need to discuss SSRI use with their doctor to weigh the pros and cons. "Always discuss medication for depression with your obstetrician in early pregnancy for advice," Stephansson says.
SSRI Use During Pregnancy: Perspective
The inexact information about who exactly took the SSRIs is a problem, Urato says. "When exposure information is inexact ... the result is often that we do not find evidence of harm from the drug," he says, although harm may exist.
A woman prescribed an SSRI who does not take it and then has a good birth outcome is classified as taking an SSRI, contributing to the finding of no harm, he says.
Urato points to other research, including links with SSRI use and miscarriage, birth defects, and other problems.
"Depressed pregnant women need good care and treatment, but medication is not the only option for treatment," he says.
In 2009, the American Psychiatric Association and the American College of Obstetricians and Gynecologists issued a joint report on treatment recommendations for depression during pregnancy. It suggests discussing the risks and benefits of antidepressants during pregnancy. It also suggests that psychotherapy may help women who prefer to avoid the drugs.