Side effects of antidepressants used during pregnancy may increase the baby’s risk of suffering a number of potential health problems, and should be minimized as much as possible, according to the findings of a new study.
Antidepressant use during pregnancy may make preterm birth more likely, increase the risk of major heart malformations and cause respiratory distress, according to a study published in the July issue of Pediatrics.
Researchers from the University of California, San Diego, conducted a study of more than 226,000 infant deliveries using data from the Optus Labs Data Warehouse. The study used antidepressant insurance claims with coverage between the last menstrual period and 35 weeks pregnancy.
More than 15,000 women used antidepressants during pregnancy, or nearly 7% of the women in the study, according to the data.
Researchers focused on five use patterns: low use with first trimester reduction (less than 10 mg/day), low sustained use of 20 mg/day, moderate use of 40 mg/day with first trimester reduction, moderate sustained use of 40 mg/day, and high-sustained use of 75mg/day.
According to the findings, taking antidepressants at a moderate sustained level, roughly 40 mg/day, increased the infant’s risk of developing serious heart deformities.
Similarly, moderate sustained use of 40 mg/day and high-sustained use of 75 mg/day were both linked with an increased risk of preterm birth.
All four levels of antidepressant dosing during pregnancy increased the risk of respiratory distress for the baby, except for the lowest level of dosing at less than 10 mg/day with a reduction in the first trimester. This level of dosing was the only amount that did not lead to increased risks for the baby.
The findings suggest a dose-response relationship, which is a strong indicator of a causal effect. The more antidepressants a woman takes during pregnancy the higher the risk the newborn will suffer from respiratory distress and other serious complications.
Researchers recommend women who become pregnant use the lowest dose of antidepressants possible that is safe for her mental well-being. Women should work with their doctor to reduce their dose during pregnancy when possible.
“Compared with the lowest-dose trajectory group, all patterns of use increased risk for neonatal respiratory distress in a dose-dependent fashion, even in the group of women in which antidepressants were reduced or discontinued early in pregnancy. In addition, moderate to high sustained antidepressant use in gestation was associated with an increased risk of preterm birth,” the researchers concluded. “Our findings support the continued use of the methodology to further delineate risk by different patterns of antidepressant use. This approach can help clinicians counsel pregnant women on the use of antidepressants during gestation.”