There’s a new study out this week, published in the Archives of General Psychiatry, on the effect of taking antidepressants during pregnancy that essentially offers the same result as other studies we’ve reported on here:
Women with untreated depression during pregnancy have a higher risk of having pre-term babies.
Women who take antidepressants during pregnancy for depression have a higher risk of having pre-term babies.
Here was the conclusion of the study as outlined in the abstract:
Untreated maternal depression was associated with slower rates of fetal body and head growth. Pregnant mothers treated with SSRIs had fewer depressive symptoms and their fetuses had no delay in body growth but had delayed head growth and were at increased risk for preterm birth. Further research on the implications of these findings is needed.
It seems this is still a chicken and egg problem — is it something underlying the genetics of depression that leads to pre-term delivery or the medication or both? What should women do?
Time and ABC News both did stories on this that were fairly balanced. They discussed the findings related to SSRI use during pregnancy, including negative impact on premature delivery and head size. They also interviewed experts on medication use during pregnancy and the treatment of women with antenatal depression who still believed its better to treat certain patients than to leave depression unchecked.
Dr. Gideon Koren, director of the Motherisk program in Canada, an organization that studies the risks of chemicals, drugs and diseases during pregnancy, believes the new study adds weight to the data favoring medication use. “Even treated depressed women often have residual depression, so this study strongly suggest that by treating depression, the overall risk for the fetus decreases,” he says. “It is very evident that the risks of unmanaged depression by far exceed those theoretical, and yet not proven risks of SSRIs (despite scores of studies).”
From ABC News:
“If we are talking about a woman who can’t take care of her health as a result of battling with moderate to severe depression, she faces risks to herself as well as the baby that are associated with untreated depression during pregnancy,” said Dr. Sudeepta Varma, clinical assistant professor of psychiatry at NYU Langone School of Medicine. “All doctors want to ensure healthy mom and baby. But if you don’t take care of the mom, there may be no baby to speak of.”
Motherisk’s Koren actually recently published a piece in the American Journal of Obstetrics and Gynecology — one that was not widely reported, I’d point out — that concluded, “When a psychiatric condition necessitates pharmacotherapy, the benefits of such therapy far outweigh the potential minimal risks of cardiac malformations, primary pulmonary hypertension of the newborn, or poor neonatal adaptation syndrome.”
As usual, more research is needed to identify significant risks as well as the safest treatments for antenatal depression. Meantime, talk to your doctor about the best plan for your individual situation and needs.