pregnancy outcomes - MGH Center for Women's Mental Health

Reproductive Age Women Need Folic Acid

A few weeks ago, January 7-13, 2008, was National Folic Acid Awareness Week at the Centers for Disease Control (CDC), therefore we wanted to take the opportunity to remind women of the importance of folic acid in the prevention of birth defects. Folic acid can prevent from 50-70% of neural tube defects, which are defects of the spine (spina bifida) or the skull (anencephaly). Spina bifida is the leading cause of childhood paralysis and anencephaly is nearly always fatal.

By MGH Center for Women's Mental Health|2020-07-27T12:48:15-04:00February 7th, 2008|Psychiatric Disorders During Pregnancy, Risk of Malformations|Comments Off

ACOG Opinion on SSRI Use During Pregnancy

Recent reports have raised questions regarding the use of selective serotonin reuptake inhibitors (SSRI) during pregnancy. To date, no professional medical association has issued formal guidelines regarding the use of SSRIs during pregnancy. However, in December the American College of Obstetricians and Gynecologists ACOG published an opinion paper on this topic that is noteworthy for its clarity and balanced review of the existing data on the reproductive safety of SSRI antidepressants (Obstetrics and Gynecology 2006;108:1601-3). The ACOG report addressed the following issues:

By MGH Center for Women's Mental Health|2015-07-28T10:50:42-04:00November 12th, 2007|Pregnancy & Medications|Comments Off

Link Found Between Anxiety and Preterm Birth

While there have been concerns regarding the reproductive safety of psychotropic medications, it must be recognized that withholding or withdrawing pharmacologic treatment for depression or anxiety during pregnancy may not always be the safest option. 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).

By Ruta Nonacs, MD PhD|2024-03-24T11:57:46-04:00October 22nd, 2007|Anxiety Disorders, Outcomes, Postpartum Psychiatric Disorders, Pregnancy Outcomes, Psychiatric Disorders During Pregnancy|Comments Off

Evaluating the Long-Term Effects of Prenatal Antidepressant Exposure

Over the last decade information has accumulated regarding the safety of antidepressants taken during pregnancy. While much research has addressed the effect of antidepressant drugs on risk for congenital malformation, less research has focused on the long-term effects of prenatal antidepressant exposure.

By MGH Center for Women's Mental Health|2015-07-28T10:14:44-04:00February 20th, 2007|Antidepressants, Long-Term Outcomes, Neurodevelopmental Disorders, Pregnancy & Medications|Comments Off

Neurobehavioral Outcomes in Children Exposed to Lithium in Utero

Driven by concerns regarding fetal exposure to psychotropic medications, many women with psychiatric illness attempt to discontinue their pharmacologic treatment during pregnancy; however, recent studies indicate that this approach may not be appropriate for all women. Dr. Adele Viguera and her colleagues at the Center for Women’s Mental Health have reported that among pregnant women with bipolar disorder, relapse rates were very high (58%) in women who discontinued maintenance treatment with lithium during pregnancy (Viguera et al 2000). Given this risk of recurrent illness, many women may consider continuing lithium treatment during pregnancy. While the teratogenic effects of first trimester exposure to lithium have been well studied, data on the long-term outcome of children exposed to lithium during pregnancy are sparse. At the 61st Annual Meeting of the Society of Biological Psychiatry in Toronto, Dr. Viguera presented preliminary data on the neurobehavioral outcomes of children exposed to lithium in utero.

By MGH Center for Women's Mental Health|2016-03-28T13:23:59-04:00July 30th, 2006|Mood Stabilizers, Neurodevelopmental Disorders, Outcomes, Pregnancy & Medications|Comments Off

Withdrawal Symptoms in Newborns Exposed to SSRIs

A recent report suggests that newborns exposed to selective serotonin reuptake inhibitors (SSRI) antidepressants such as Prozac, Zoloft, Celexa and Paxil may be at risk for developing withdrawal symptoms after delivery (Levinson-Castiel 2005). However, the investigators also noted that the symptoms usually disappeared within 48 hours and did not require medical intervention.

By MGH Center for Women's Mental Health|2015-07-28T09:51:11-04:00April 24th, 2006|Antidepressants, Neonatal Symptoms, Outcomes, Pregnancy & Medications|Comments Off

SSRIs and Persistent Pulmonary Hypertension of the Newborn

These findings are likely to generate significant anxiety among child-bearing women who suffer from depression who would like to maintain antidepressant medication during pregnancy. Future studies are needed to better understand the risk of PPHN in this setting.

By MGH Center for Women's Mental Health|2025-07-26T08:55:25-04:00April 24th, 2006|Antidepressants, Child Outcomes, Neonatal Symptoms, Pregnancy & Medications|Comments Off

Should SSRIs Be Discontinued Prior to Delivery?

About 10-15% of women suffer from depression during pregnancy. The rates are probably even higher among those women who have histories of depression prior to pregnancy. Thus, many women with recurrent illness make the decision to remain on antidepressant during pregnancy. While there have been many studies supporting the reproductive safety of certain antidepressants, including Prozac and the tricyclic antidepressants, during pregnancy, concerns have emerged as to whether antidepressants, including the selective serotonin reuptake inhibitors (SSRIs), may increase the risk of adverse events in the newborn.

By MGH Center for Women's Mental Health|2015-07-22T14:41:25-04:00June 13th, 2005|Antidepressants, Child Outcomes, Neonatal Symptoms, Pregnancy & Medications|Comments Off

Selecting an Antidepressant During Pregnancy

Most women and their doctors try to avoid using medications during pregnancy. Of greatest concern is that a medication used during pregnancy may in some way harm the developing fetus or, at the very worst, cause a birth defect. But what happens when a pregnant woman needs to take a medication?

By MGH Center for Women's Mental Health|2015-07-20T10:15:46-04:00May 6th, 2001|Anxiety Disorders, Child Outcomes, Depressive Disorders, Medication, Pregnancy & Medications, Psychiatric Disorders During Pregnancy, Risk of Malformations, Treatment|Comments Off

Bipolar Disorder and Pregnancy

Unfortunately the mood stabilizers most commonly used to treat bipolar disorder (including lithium and valproic acid) can increase the risk of certain types of birth defects or congenital malformations in children exposed to these medications during the first trimester of pregnancy. For this reason, many women with bipolar disorder choose to discontinue maintenance treatment during pregnancy. However, we have observed very high rates of illness during pregnancy among these women who discontinue treatment; over half of the women relapse, most frequently during the first trimester.

By MGH Center for Women's Mental Health|2016-03-28T13:38:39-04:00January 6th, 2001|Bipolar Disorder, Prevalence & Risk Factors, Psychiatric Disorders During Pregnancy|Comments Off