Discovering you’re pregnant is a life changing moment. If you are like most women, the drive to protect and care for your child begins the moment you know you have conceived. As a result, you carefully evaluate the foods, beverages, and chemicals you ingest, especially those that are able to cross the placenta.
So, what do you do when you have a medical condition that requires taking a prescription with potentially negative side effects for your developing fetus? This is a question that affects a growing population of women who require medication for the adequate treatment of their depression. The question can only be answered by understanding the potential risks of untreated maternal depression to your pregnancy and the potential risks and benefits of taking your medication.
Antidepressant SSRIs can cross the placenta, but what is the effect?
One of the largest categories of antidepressant medications are referred to as Selective Serotonin Reuptake Inhibitors (SSRIs). According to the Harvard Health Blog, as many as 23% of women are taking some form of antidepressant by the time they reach age 40. SSRIs are able to cross the placenta and can pass to the baby via breast milk, and they are currently considered first-line medical treatments for depression in pregnancy. There has been a great deal of research evaluating the effects of taking these medications while pregnant and the results are somewhat mixed. Exactly if and how they effect the fetus is still under debate.
New study contradicts historical findings
Historically, studies have shown that women who take SSRIs while pregnant have higher incidences of miscarriages, stillborn babies, and birth defects, as well as higher rates of infant death within the first year. However, a recent study reports SSRIs may not be as risky during pregnancy as previous studies indicated. A group of Swedish researchers looked at more than 1.6 million births across five European countries. Of these births, approximately 30,000 women had prescription for an SSRI.
Once the researchers accounted for women who smoked, as well as maternal age, there was no increase in still birth or newborn death rates. This should be good news for pregnant women who take prescription SSRIs. However, some researchers are skeptical. Adam Urato is a doctor and an assistant professor of obstetrics and gynecology at Tufts University School of Medicine. He says, “I don’t find the study results particularly reassuring…This study looked at information on dispensed drugs, not ingested drugs, and these numbers are often quite different.”
What about the risks of untreated depression?
Untreated maternal depression in pregnancy has been associated with higher rates of spontaneous abortion, preterm birth, poor maternal responsiveness to their infants, suicide attempts, and postpartum depression. It is also associated with significantly higher rates of psychological problems in children who were born to mothers with depression. These risks, combined with conflicting research within the medical community, make it very difficult for pregnant women to evaluate their options.
What should I do if I am on anti-depressants and find out I am pregnant?
This is not the kind of decision that can be easily made by searching the internet for answers. It is very important to discuss your situation with your healthcare provider to understand the trade-offs and create a prenatal care plan that’s right for you.