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Antidepressant Use in Pregnancy May Affect Baby

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How Big a Risk? continued...

"A couple of things stood out in terms of its implications. First, less than 12% of the identified studies appropriately accounted for maternal depression, which is a known risk factor for birth complications. So with so few studies to go on, it leaves both researchers and clinicians in a tight spot with regard to interpreting the effects of antidepressant medications."

She says the authors also made an important distinction between statistical and practical significance.

"For example, for gestational age, exposed babies were born significantly earlier, but only by about half a week. So on average for most of these outcomes, antidepressant-exposed babies were still within normal limits," she says.

Johnson says that moms-to-be with a history of depression should not stop their medication, but should instead talk with their doctor about it.

"Too often you see women who find out they're pregnant and either on their own or on the advice of a physician suddenly stop all psychiatric medications. And this puts both the mother and the baby at risk, especially if it's a sudden stop," she says.

"I think a much better scenario is for a woman to see a psychiatrist, someone experienced in treating peri-partum mood and anxiety disorders and preferably prior to conception, so that they can work together to implement the right treatment for that particular patient. That's better than having a knee-jerk reaction to some of these studies," she says.

To see a version of this story for physicians, visit Medscape, the leading site for physicians and health care professionals.

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