Following a new publication in the British Medical Journal there has been renewed media coverage regarding antidepressants and their impacts during pregnancy. The Swedish study revealed that women who used antidepressants throughout pregnancy have a higher risk of giving birth to babies with high persistent pulmonary hypertension (PPHN). PPHN refers to high blood pressure in the arteries of the lungs and it can be life threatening. PPHN causes shortness of breath and other difficulties breathing, it also has strong links to heart failure. The specific antidepressant drugs that cause these anomalies are serotonin reuptake antidepressants (SSRIs) such as paroxtine (Paxil), sertraline (Zoloft) and fluoxetine (Prozac).
The Swedish study assessed 1.6 million babies born between 1996 and 2007 from Finland, Sweden, Denmark and Norway. Conducted by the Karolinska Institute in Stockholm, the research compared the births from mothers who had used antidepressants during their pregnancy with those that had not used antidepressants. The study also included women with previous psychiatric diagnosis that didn’t use antidepressants during their pregnancy. At 33 weeks old, the babies were assessed by the research team. The results revealed that babies born to mothers who had taken SSRIs during pregnancy had a higher incidence of PPHN than babies born to mothers who didn’t use antidepressants during their pregnancy. The study showed that three babies with PPHN were born for every 1, 000 women using SSRIs in the first trimester and these results doubled if SSRIs were used late in the pregnancy.
Three in every 1, 000 babies doesn’t sound excessive however, PPHN is a very severe condition and the risk of giving birth to a baby with PPHN can be reduced by avoiding antidepressants during pregnancy. The detrimental effects of SSRIs during pregnancy are further highlighted by an earlier Finnish study published in July 2011. Findings of this research showed that exposure to SSRIs during the first trimester can increase the risk of the baby developing major congenital anomalies, especially heart conditions. The Finnish research results support those of the Swedish study in that using SSRIs during pregnancy can cause life threatening implications for the unborn child.
Certainly these findings are concerning for any pregnant women using antidepressants or any women on antidepressants and considering pregnancy. If you’re taking antidepressants and thinking about becoming pregnant it’s important to consult your physician and examine ways to stop using antidepressants prior to pregnancy. There are other alternatives to SSRI medications to treat depression and it’s a good idea to examine all of these options. If you’re taking antidepressants remember that coming off this medication must be done slowly through a weaning process to avoid dangerous side effects. If you’re already pregnant then it’s critical that you don’t suddenly stop taking antidepressant medication, this can have serious implications for both your own health and that of your unborn child. Also, if you have had suicidal tendencies in the past when depressed than it‘s really important not to stop using medication without first seeking medical and ideally, psychiatric advice. Your pregnancy should be a happy time while you anticipate welcoming your new baby into the world, so take on board all the advice and help that you can.