• preterm birth

    Measuring the Effects of Antidepressants versus Untreated Depression on Pregnancy Outcomes

    Multiple studies have demonstrated an increased risk of poor neonatal adaptation associated with exposure to selective serotonin reuptake inhibitor (SSRI) antidepressants in late pregnancy.  Results in the literature consistently indicate that about 25%-30% of infants exposed to SSRIs late in pregnancy manifest symptoms of poor neonatal adaption, including jitteriness, restlessness, increased muscle tone, rapid breathing.  These symptoms are transient, resolving spontaneously with no specific medical intervention.

    Prepregnancy Depressive Mood is a Risk Factor for Preterm Birth

    There have been multiple studies suggesting that depression during pregnancy increases the risk for preterm labor.  Most studies do not attribute this increase in risk to antidepressant exposure, but to the effects of the depression itself.  The mechanism is believed to be related to increased levels of corticotropin releasing hormone (CRH) which is triggered by stress.  Elevated levels of CRH have been shown to be a predictor of preterm birth. 

    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).

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