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At the 2012 meeting of the American Society for Reproductive Medicine (ASRM), a review of literature on the use of SSRI antidepressants in pregnancy was presented.
Prof Carmine Pariante, Professor of Biological Psychiatry and Head of the Sections of Perinatal Psychiatry & Stress, Institute of Psychiatry, Kings College London, said:
“While it is important that reviews like this one look at the overall body of literature, none of these findings is new as we have known for a few years that the use of antidepressants in pregnancy is associated with a small but statistically significant increase in the risk of obstetric complications, prematurity and possible autism in the offspring.
“However the main limitation of all of these studies is that it is virtually impossible to disentangle the role of antidepressants in these adverse outcome as compared with the role of depression in pregnancy per se. Studies have shown that depressed women who are not receiving antidepressants have similarly increased risks of obstetric complications, prematurity, and increased risk of adverse behavioural problems in the offspring. This is likely due to changes in the biology of the utero environment due to the depression in the mother. Therefore, we cannot really say if much of the negative effects of an antidepressant medication in pregnancy is due to the drug itself as opposed to the fact that the mothers are depressed in the first place.
“Clearly this is an important area and new evidence is always welcome, but we do know that untreated depression in pregnancy has also very severe adverse effects on the offspring, it persists overtime to become severe post-natal depression, and it disrupts the crucial mother-infant interaction in the first week of life. Therefore, we recommend that each decision on whether to prescribe antidepressants or not in pregnancy is discussed with the individual woman based on her clinical and personal circumstances.”