Antidepressant use during pregnancy

Published on: 06/06/2015

A study published this week in JAMA, suggests that use of antidepressants late in pregnancy may be associated with a small increased risk of persistent pulmonary hypertension of the newborn (PPHN). This is a rare but very serious condition that occurs when a newborn’s circulation system in its lungs doesn’t adapt to breathing outside the womb. It can lead to long term health consequences including chronic lung disease, seizures, and neurodevelopmental problems and in some cases is fatal.

The study examined nearly 3.8 million pregnancies and is the largest study on this issue to date.  The RCOG described it as “extremely useful” as it had used a robust methodology and careful efforts had been made to account for any confounding factors.

Though the researchers and other experts have described the findings as the best evidence currently available on antidepressant use in late pregnancy and the risk of PPHN, they did also highlight that the study showed that the overall risk was still very low and the risk increase appears more modest than suggested in previous studies.

Dr Patrick O’Brien, spokesperson for the Royal College of Obstetricians and Gynaecologists (RCOG) said: “In a sense, these results are reassuring. The findings suggest a very small absolute risk…Depression in pregnancy can be very serious for a woman and can also impact on the health of her baby, so we must consider the benefits of antidepressant medication in such cases. Our continued advice for pregnant women suffering with depression would be that the benefits outweigh the risks, however, all pros and cons should be discussed and weighed up by a woman, together with her obstetrician.”

 

Read the study here

Read the RCOG response to the study here