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Antidepressants during pregnancy don't raise infant death risk
January 3rd, 2013
02:26 PM ET

Antidepressants during pregnancy don't raise infant death risk

It's a heated question: should women take antidepressants during pregnancy? Some experts argue for it and some against, but a new study may ease the minds of women facing the decision.

Researchers say taking a common type of antidepressant does not increase the risk of having a stillborn child or losing an infant early in life. The study was published in this week's Journal of the American Medical Association (JAMA).

"It does strengthen the view that these meds are safer than we once thought," explains Dr. Jennifer Payne, director of the Women's Mood Disorders Center at Johns Hopkins School of Medicine in Baltimore.

Although there is much discussion about the risks of using antidepressants, experts emphasize that failing to treat depression can also lead to health problems for mom and baby.

The study

Researchers looked at the medical records of more than 1.5 million newborns and their mothers from Norway, Denmark, Sweden and other Nordic countries. About 29,000 of the mothers-to-be had filled a prescription for SSRIs, or selective serotonin reuptake inhibitors - the most common type of antidepressant prescribed for depression during pregnancy.

The results

At first it appeared that those taking these meds were more likely to deliver a stillborn or lose their baby before its first birthday, compared to women not taking SSRIs, according to the study. But when the researchers factored in the severity of a woman's depression, as well as her smoking habits and age, then the outcomes between the two groups were virtually the same.

Depression 101

Depression is common in pregnancy, affecting between 14% and 23% of pregnant women, according to the American Psychiatric Association. When left untreated or undertreated, women with depression often don't eat or sleep properly, tend to miss prenatal medical visits, and may turn to alcohol or take up smoking. As a result these moms may deliver their babies early, give birth to low-birth weight infants, or find their newborns have other health issues.

It's important for patients and doctors to get the condition under control, experts say. If the depression is mild or moderate, talk therapy or other types of counseling may help, but when severe, antidepressants may be prescribed as well.

Added perspective

A study released last October in JAMA raised red flags about the health risks from SSRIs for expectant moms, and discouraged their use.

Experts know there are risks tied to using these drugs, such as increased risk for miscarriage, early delivery, low infant birth weight and others. But this new study suggests that when it comes to infant mortality, experts need to explore more than just the effects of medication on the health of mom and baby - an unhealthy maternal lifestyle and the severity of the depression are key factors as well.

Tips for pregnant women

What should a woman do if she is planning a family or gets pregnant while taking an antidepressant?

- First and foremost, don't panic and talk to your doctor before you do anything. Women "should not stop their medication suddenly, period, because this can lead to a 70% chance of relapse," explains Payne. This is particularly true for those with recurrent depression, she adds.

- Pregnant women with severe depression who have attempted suicide are advised to stay on their medicine. But, again, check with your doctor.

- If you are not experiencing symptoms and want to discontinue the medication, talk to your psychiatrist or physician about whether or not tapering off would work for you. Psychotherapy might replace or augment your medications.

- And finally, "Any woman with a psychiatric illness or any woman, period, who is or wants to be pregnant should be doing everything else from a healthy perspective: they should exercise, they should take their prenatal vitamins, drink lots of water, get good sunshine, and try not to get stressed," explains Payne.


soundoff (11 Responses)
  1. RJ

    "It does strengthen the view that these meds are safer than we once thought" - Haha, yeah, until you try mixing your diet with an MAOI and instantly die. Very safe, indeed.

    January 4, 2013 at 21:18 | Report abuse | Reply
  2. Fifi

    still no where are we discussing the effects of the long term of what happens when the baby grows up. What happens to there developing serotonin levels invetro and through childhood because this mother took a anti-depressant. So it doesn't kill the baby exactly what does it do to this baby???

    January 10, 2013 at 05:37 | Report abuse | Reply
  3. Mike

    They left out the part about ssri's increasing the chances of an unborn child developing autism later in life. Way to go CNN! Don't upset your advertisers.

    January 11, 2013 at 17:40 | Report abuse | Reply
  4. BobG

    This just in. Gigantic Pro-Life rally in Washington. Larger turnout than last year's 400,000. If you watch only CNN for your news, you probably weren't even aware there was anything going in DC besides gun control debate and Hillary,

    January 25, 2013 at 22:14 | Report abuse | Reply
  5. lauren

    It's great that your child MAY survive. But unless you are on the verge of comminting suicide and killing you and you baby, is it really worth the risk of not having the healthiest baby possible? Depression is no joke, but it's not going to improve when you realized it's possibly your fault that your child has congnetive issues.

    February 3, 2013 at 07:45 | Report abuse | Reply
  6. Jill

    They make it sound as if this research were conclusive. I'm looking up this study right now, and the possible effects of SSRIs are a bit more broad; the study is too new. I appreciate that CNN is trying to keep us updated and whatnot, but the wording needs to be worked on. Neither of the statements given by the researchers were as conclusive or final as this reporter makes it out to be. The risks of untreated depression versus medically treated depression on a(n) zygote/embryo/fetus are NOT weighed evenly. SEVERE MDD should definitely be treated with medication, and THEN it's safer for the child prenatally, but the majority of people taking SSRI medication do not actually need it. This is backed up by a study; they're essentially placeboes in lesser cases of MDD and are really only beneficial for those way outside of the curve (the bell curve). I could go on, but the point is, this stuff is not as simple as this article makes it out to be. SSRIs aren't either GOOD or BAD for in-utero chilren, but MAY be good or bad for them, and are not definitively teratogens (or not), and not all MDD patients need medication (in fact very few benefit from it)/are going to behave in behavior maladaptive to the baby. Think critically.

    February 7, 2013 at 23:49 | Report abuse | Reply
    • Jill

      http://ehis.ebscohost.com/eds/pdfviewer/pdfviewer?sid=7b1ef050-fb87-4fc4-924e-ce665a36cc59%40sessionmgr13&vid=3&hid=15

      (For anyone who wants to read the study.)

      February 7, 2013 at 23:51 | Report abuse |
  7. Chelle

    What about birth defects or behavioral problems later on? I felt very pushed into taking my meds while pregnant with my daughter and while assured it was completely safe, she was born with severe hearing impairment and developmental delays. At two years old, they are still unsure what the cause is but I have a strong feeling the pills had a hand in it. None of her problems run in my family and my other children are perfectly healthy. I love my baby girl more than the world but if I could I would go back and refuse those pills and found another way to help myself.

    February 20, 2013 at 01:24 | Report abuse | Reply
  8. JM

    Drugs that affect brain serotonin concentrations/regulation during development undoubtedly alter brain morphology in rodents. There are many studies on this. The question is, what does this mean functionally? I'm not sure if we know yet. We will find out when the kids grow up. There's already many lawsuits going on about various birth defects from SSRIs. More data needed.

    March 2, 2013 at 22:06 | Report abuse | Reply
  9. Fred

    What about birth defects or behavioral problems later on?.....

    so

    March 25, 2013 at 08:32 | Report abuse | Reply
  10. findmydream

    This article doesn't mention anything about withdrawal from the SSRI at birth for the baby. I was taking Celexa while I was pregnant with my daughter. When she was born, she had to be taken right away and put in an isolete, oxygen, heart monitors, the works. There was no other reason for it. On the flip side, I had post-partum depression with my son and wasn't put on meds until he was 7 weeks old. I don't feel I ever really bonded with him and he has ADHD which I was told by his pediatrician, was caused by my post-partum depression.

    August 20, 2013 at 14:13 | Report abuse | Reply

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Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.