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    Antidepressants Linked to Newborn Problems

    SSRI Use During Pregnancy Associated With Premature Birth, Other Health Problems for Babies


    The study did not find significant differences between birth weight or head circumference between infants in any of the three groups.

    Charles Lockwood, MD, chairman of the department of obstetrics, gynecology and reproductive sciences at Yale University, says that because women who are taking antidepressants are more likely to be sicker than those who do not -- and thus more likely to deliver prematurely as a result of the stress of their mental illness -- it’s possible the results were slightly confounded by this phenomenon.

    “It’s sort of like the chicken and egg problem,” says Lockwood, who co-authored guidelines on the treatment for depression during pregnancy published jointly this August by ACOG and the American Psychiatric Association. “But the study still adds further weight to the possibility that the SSRIs themselves may be related to prematurity,” he says. Lockwood was not involved in the current study.

    Treating Depression During Pregnancy an Ongoing Issue

    The current study adds to the growing body of research devoted to helping decide whether pregnant women should take antidepressants during their pregnancy.

    Previous studies have shown that the drugs lead to higher rates of NICU admissions because of withdrawal symptoms in newborns, and to higher rates of pulmonary hypertension -- high blood pressure in the arteries that serve the lungs. Last month, another Danish study showed that women taking Celexa and Zoloft early in pregnancy gave birth to babies with a slightly higher rate of a certain heart defect.

    Despite such problems, Lockwood warns of the dire potential outcomes of avoiding medications in some women who suffer from depression. “We must always be focused on the mother’s health because the greatest risk of under-treating a depressed mother is suicide -- and that’s a really bad risk for any fetus to have,” he says.

    Past studies have also shown higher rates of low birth weight and premature delivery as additional risks of being depressed while pregnant.

    Although the exact mechanism is unclear, some animal studies have suggested that SSRIs might interfere with adequate blood flow to the uterus, thereby causing problems.

    Pregnancy itself could cause onset of new depression or an exacerbation of pre-existing depression, says Lockwood. “Being pregnant can bring on a lot of different stresses for a woman -- financial worries, physical distress from feeling nauseous and exhausted -- it makes sense that there’s something about pregnancy in its essence that can trigger depression,” he says. Some theories suggest that fluctuations in certain hormone levels including progesterone and corticotropin-releasing hormone could also be part of the problem.

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