(Ivanhoe Newswire) -- Exposure to a certain class of antidepressant
medications during pregnancy may put a baby at risk for preterm birth, a low
five-minute Apgar score (a measure of overall health of the baby) and admission
to the neonatal intensive care unit, according to a recent report.
One in 10 pregnant women is estimated to have depression comparable in frequency
and severity to postpartum depression. "Depression, antidepressants and
lifestyle factors associated with depression may influence pregnancy outcomes
and newborn health," study authors are quoted as saying. "The safety profile of
antidepressant medication in pregnancy is undetermined, but depression during
pregnancy can be serious and has been associated with an increased maternal
mortality."
A class of antidepressants known as selective serotonin reuptake inhibitors (SSRIs)
have been used during pregnancy since the early 1990s and are recommended as the
first choice for pregnant women in many countries.
Najaaraq Lund, M.D., of the Bandim Health Project, Indepth Network in Bissau,
Guinea-Bissau, and Aarhus University in Aarhus, Denmark, and colleagues studied
women receiving prenatal care from 1989 to 2006. They compared birth outcomes
including gestational age, birth weight and Apgar score among babies born to 329
women who were treated with SSRIs, 4,902 who had a history of psychiatric
illness but were not treated with SSRIs and 51,770 who had no history of
psychiatric illness.
Women who took SSRIs during pregnancy gave birth an average of five days earlier
and had twice the risk of preterm delivery as women with no history of
psychiatric illness. Infants exposed to the medications in utero were
significantly more likely to have a five-minute Apgar score of seven or below
(seven is a general indicator of good infant health) or to be admitted to the
neonatal intensive care unit (NICU). Head circumference and birth weight did not
differ among the three groups.
SSRIs have been shown to readily cross the placenta and appear in the umbilical
cord blood of infants, the authors noted. Several previous observations have
described withdrawal symptoms in infants born after exposure to the medications.
In this study, exposed infants admitted to the NICU experienced symptoms that
could have been caused by withdrawal from or adverse effects of SSRIs, including
jitteriness, seizures, respiratory problems, infections and jaundice.
"The study justifies increased awareness to the possible effects of intrauterine
exposure to antidepressants," the authors concluded. "However, treatment of
depression during pregnancy may be warranted and future studies need to
distinguish between individual SSRIs to find the safest medication."
SOURCE: Archives of Pediatrics & Adolescent Medicine, October 2009
