Antidepressants in Pregnancy & Lung Risk in Babies
But, overall risk of 'persistent pulmonary hypertension' remains low, study finds
Treatments are available for persistent pulmonary hypertension, and most babies with the condition do well, according to Grigoriadis. But, she said that long-term risks are an area that needs more research.
The new study, published online Jan. 14 in the BMJ, pooled the results of seven previously completed studies on SSRI use during pregnancy and the risk of persistent pulmonary hypertension.
The analysis found that taking SSRIs during early pregnancy didn't lead to a significantly increased risk of the lung condition. But, when taken late in pregnancy, these medications were linked to a 2.5 times increase in the risk of persistent pulmonary hypertension.
That means that between 286 and 351 women would need to be treated with an SSRI in late pregnancy to result in an average of one additional case of persistent pulmonary hypertension, according to the study.
One difficulty for the researchers was pinning down the precise meaning of "late" pregnancy, as studies in the review had varying definitions. Late pregnancy could mean anytime during or after the 20th week, or it could mean during the third trimester, among other time frames.
Although the study found an increased risk of the lung problem, it wasn't designed to prove that the medications directly caused the problem. Grigoriadis said it's not clear exactly how SSRIs could cause persistent pulmonary hypertension.
She said that women shouldn't stop taking their medications, instead they should talk to their doctors if they have concerns.
"Decisions on treatment need to be personalized. Women need to make informed decisions by taking in all the risks of depression and its treatments. Psychosocial treatments [such as counseling] are appropriate for some women, depending on how severe the depression is, and how quickly [a woman] might respond to treatment," Grigoriadis said.
For her part, Frieder said, "It's good to see someone put all of these studies together in a uniform way. It makes me feel more comfortable about giving these medications. The risk is low, but it needs to be put into context with a woman's history. Treatment choices need to be individualized."