Essential Reads: Antidepressants Do Not Increase the Risk of Miscarriage
SSRIs were not associated with an increased risk of miscarriage.
Do SSRIs Increase the Risk of Postpartum Hemorrhage? Maybe, But Not By Much
Selective serotonin reuptake inhibitor (SSRI) antidepressants may affect platelet aggregation and thus may increase the risk of bleeding. Several studies have sought to determine if exposure to SSRI antidepressants in late pregnancy is associated with an increased risk of postpartum hemorrhage.
Eating Disorders and Their Impact on Pregnancy Outcomes
Eating disorders are relatively common among women of reproductive age, yet the literature on the effects of maternal eating disorders (ED) on pregnancy outcomes is relatively sparse. There has been concern that eating disorders may negatively affect gestational weight gain. Previous studies have demonstrated an association between maternal anorexia nervosa (AN) (both active and past) and lower infant birthweight (as compared to women with no history of ED); however, calculations of the magnitude of this effect have been inconsistent.Â
SSRI Exposure During Pregnancy Does Not Appear to Affect Infant Growth
Some studies have shown an association between in utero exposure to antidepressants and various pregnancy outcomes, including preterm delivery, low birth weight, and lower Apgar scores; however, these outcomes have also been observed in infants born to depressed mothers who are not taking medication. Thus, it has been difficult to determine if there is a causal relationship between antidepressant exposure and these negative pregnancy outcomes or if untreated maternal depression is itself responsible for these negative outcomes.Â
Antidepressants and Pregnancy: A Meta-Analysis Puts the Risks into a Larger Context
While some studies have shown an association between in utero exposure to antidepressants and various pregnancy outcomes, including preterm delivery, low birth weight, and lower Apgar scores, these outcomes have also been linked to untreated maternal depression. Thus, it has been difficult to determine if there is a causal relationship between antidepressant exposure and negative pregnancy outcomes or whether maternal depression is itself responsible for these negative outcomes.
No Increase in Risk of Infant Mortality in Women Taking SSRIs During Pregnancy
While there has been a great deal of attention paid to the risks of exposure to antidepressants, particularly the selective serotonin reuptake inhibitors (SSRIs), during pregnancy, there has been comparatively little information on the risk of stillbirth and infant mortality in this population. In a recent population-based cohort study utilizing data from all Nordic countries (Denmark, Finland, Iceland, Norway, and Sweden), researchers assessed the risk of stillbirth and infant mortality associated with the use of SSRIs during pregnancy.
Depression During Pregnancy Increases the Risk of Preterm Birth
Some, but not all, studies have indicated that depression during pregnancy increases the risk of preterm birth. A recent study published in the American Journal of Obstetrics and Gynecology is one of the largest to address this question.
Pregnancy Outcomes in Women with Eating Disorders
Most studies have shown that women experience an improvement or remission in eating disorders during pregnancy; however, studies assessing how eating disorders may affect pregnancy outcomes have yielded conflicting results. While some studies have demonstrated no negative effects, others have demonstrated higher miscarriage rates among women with bulimia nervosa. In addition, women with histories of eating disorders have been shown to be significantly more likely to experience preterm delivery and to give birth to babies small for gestational age.
Use of Antipsychotic Medications in Pregnancy Increases Risk of Gestational Diabetes
Atypical antipsychotic medications are commonly used for the treatment of schizophrenia and bipolar disorder. Despite the increasing use of these medications in women of child-bearing age, there is still relatively little data regarding the reproductive safety of these medications.Â
Anxiety During Pregnancy Predicts Worse Outcomes
In treating pregnant women with mood or anxiety disorders, we tend to focus primarily on the reproductive safety of psychotropic medications; however, it must be recognized that withholding or withdrawing pharmacologic treatment for depression or anxiety during pregnancy may carry some degree of risk. Untreated psychiatric illness in the mother cannot be considered a benign event, and a number of studies have indicated that depression during pregnancy may negatively affect pregnancy outcomes (reviewed in Bonari 2004).