Study Finds Low Risk Associated With Antidepressant Use While Pregnant

The findings, from Brigham and Women's Hospital, are contrary to a 2006 warning from the FDA.

Expectant mothers are forced to cut many things out of their diets while pregnant, from caffeine to alcohol. But a new study out of Brigham and Women’s Hospital (BWH) says one controversial substance may be able to stay: antidepressants.

The study is the latest in a string of conflicting recommendations regarding the use of antidepressants while pregnant. First, in 2006, the FDA warned that taking serotonin reuptake inhibitors (SSRIs), a common type of antidepressant, during pregnancy could increase the risk of persistent pulmonary hypertension (PPHN), which can lead to respiratory failure, in newborns. The FDA called its own findings “premature” in 2011, but the use of SSRIs while expecting has remained a contested issue since. This study, however, may settle the debate.

Led by BWH epidemiologist Krista Huybrechts, the researchers studied the medical data of more than 3 million women throughout the course of their pregnancies, then checked how many of their babies were born with PPHN. Though rates of PPHN were slightly higher for the 3.4 percent of women who took SSRI antidepressants during the study, the researchers concluded that the risk was not significantly greater, especially when factors like overall health and lifestyle were also taken into account. No increased risk was found for those using non-SSRI antidepressants.

“I think that the most balanced and fair conclusion is to say that there might be an increase in risk, but the most important conclusion is that it’s much smaller than some of the initial studies had suggested,” Huybrechts says.

PPHN, however, is not the only risk tied to antidepressant use while pregnant; other studies have examined the link between antidepressants and conditions like cardiac malformation, genital malformation, and pre-term birth. Huybrechts says that she personally has been involved in research that largely debased the correlation to cardiac malformation, but she admits that using antidepressants can be a complicated issue for women.

“I think what is important is for women to decide based on the severity of their underlying illness—which determines how important it will be to continue taking antidepressants during pregnancy,” Huybrechts says. “It’s really an individual decision to weigh all these risks, and PPHN is really just one component of that complex puzzle.”