Antidepressants are commonly prescribed to manage depression or anxiety disorders. Pregnant women who require this medication may be concerned about the effects it may have on the fetus.

Antidepressants are considered a category C drug for pregnancy, meaning that they may pose a risk to the fetus. However, the benefit of taking antidepressants may outweigh the potential risks of abruptly stopping this medication. In this article, we will explore the current studies on antidepressants and pregnancy and their findings.

Types of Antidepressants

Antidepressants are divided into four categories: selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants (TCAs), and atypical antidepressants.

SSRIs and SNRIs are the most commonly prescribed types of antidepressants for pregnant women.

Incidences of Antidepressant Use in Pregnancy

Recent studies show that about 10% of pregnant women in the United States take antidepressants during their pregnancy. Among them, 60% are on SSRIs, and 20% are on SNRIs.

Risks Associated with Antidepressants and Pregnancy

Antidepressants that cross the placenta barrier may affect the fetus’s exposure to serotonin, a neurotransmitter that regulates mood, sleep, and other bodily functions.

Studies suggest that exposure to serotonin reuptake inhibitors (SRIs) during pregnancy may increase the risk of developing obstetric complications such as preterm birth, low birth weight, and neonatal respiratory distress syndrome. Some studies have also shown an increased risk of congenital abnormalities, withdrawal symptoms, and persistent pulmonary hypertension of the newborn.

Benefits of Antidepressants and Pregnancy

Persistent depression or anxiety during pregnancy may pose risks to both the mother and the fetus. Studies suggest that untreated depression or anxiety during pregnancy can result in poor maternal health, premature birth, and low birth weight.

Moreover, untreated mental health disorders can lead to postpartum depression and impair the mother’s ability to care for her newborn. Conclusively, treatment with antidepressants may improve the mother’s quality of life and reduce the risk of complications for both the mother and the baby.

SSRIs on Pregnancy Outcome

Several studies have looked into the effects of SSRI usage on pregnancy outcomes. One of the largest studies suggests that SSRI usage during pregnancy may increase the risk of preterm birth, low birth weight, and respiratory distress syndrome.

The research found that the complications are proportional to the length of SSRI usage and the dose of the medication taken during pregnancy. Another study reported that maternal SSRI treatment increased the risk of congenital heart defects in infants.

SNRIs on Pregnancy Outcome

Studies on SNRIs and pregnancy are currently limited. A research study suggested that there might be an increased risk of oral cleft defects in infants born to women who used SNRIs during the first trimester.

Antidepressant Use in the First Trimester

The first trimester is a crucial period in the development of the fetus. Studies suggest that antidepressant usage during the first trimester may increase the risk of congenital malformations and increase the risk of heart defects in infants.

A recent study reported that the risks of malformations are proportional to the dosage of the medication taken during the first trimester.

Antidepressant Use in the Third Trimester

The third trimester is the period during which the fetus gains weight and matures. Studies suggest that exposure to antidepressants during this period may cause neonatal withdrawal symptoms.

Newborns who are exposed to antidepressants during the third trimester may experience muscle stiffness, respiratory distress, hypoglycemia, and decreased body temperature.

Conclusion

The current studies suggest that taking antidepressants during pregnancy may cause several obstetric complications such as preterm birth, low birth weight, respiratory distress, and congenital malformations.

However, not taking antidepressants while pregnant may increase the risk of depression, anxiety, and other untreated mental health disorders, which can result in maternal and neonatal complications. The selection of the appropriate antidepressant and the optimal dosage for the mother is critical to balance the potential risks and benefits for both the mother and the baby.