Three research teams analysing the effects of taking antidepressants during pregnancy on both the mothers and their children showed that the neurodevelopment and the long-term behaviour of the latter are not affected negatively. On the other hand, the use of the antidepressants is said to be weakly linked with an increased risk of postpartum haemorrhage. The findings have been published in An International Journal of Obstetrics and Gynaecology (BJOG).
A large proportion of pregnant women are affected by depression and anxiety during pregnancy or in the postnatal period. The treatment for this condition includes the use of antidepressants such as selective serotonin reuptake inhibitors (SSRIs). However, it is not clear whether the pills constitute any risk for the foetus/ baby or to the mother herself. The first new study, carried out by researchers from the Norwegian Institute of Public Health, therefore, analyses the effects of SSRI on the health of the mother and the long-term development of the child.
The motor skill development of 51,404 toddlers at the age of 3 was analysed in terms of the effects of prenatal exposure to SSRIs. The 159 mothers who participated in the study reported having used SSRIs for a long period of time during pregnancy. When the children were compared with those unexposed to the antidepressants during pregnancy, it was revealed that they had a slight delay in the development of fine and gross motor skills. However, the difference is not deemed to be considerable, according to the researchers, and thus they did not recommend any change in clinical practice.
“Our results show that treatment with SSRIs during longer time periods in pregnancy was weakly associated with a delayed motor development at age three. However, only a very small number of children had a severe delay. Even though we did take into account maternal symptoms of depression we still did not have complete information on the severity of the maternal depression in the different groups. Effective treatment of depression during pregnancy is essential and these results should not discourage healthcare professionals from prescribing or continuing antidepressant treatment to those who need it,” says lead author, Marte Handal from the Norwegian Institute of Public Health.
Another study recently carried out by a team of researchers from Australia showed that prenatal exposure to SSRIs did not appear to impact significantly on the behaviour of 7-year-olds. However, the scientists did find that untreated prenatal depression was linked with a greater risk of the children to display hyperactivity, inattention, and peer problems – an increased risk that was not demonstrated in those children whose mothers would take the SSRIs during pregnancy.
The third study entailed the risk of postpartum haemorrhage in mothers consuming SSRIs in the final 3 months of pregnancy. It was found that those not taking antidepressants had a 11 % risk of postpartum haemorrhage while women who used SSRIs had a 16 % risk. However, the researchers write that this increased risk might not be the direct effect of the use of SSRIs themselves.
Dr Luke Grzeskowiak, lead author of the studies (the second and the first one) from The University of Adelaide, Australia, said:
“It is reassuring to find that prenatal exposure to antidepressants did not affect a child’s behaviour at age 7, however as with any medication, the benefits and risks but always be considered.
“Regarding our other study, overall the risks for postpartum haemorrhage are largely unknown. We found separate increases in risk with placenta praevia, prolonged labour, hypertension and assisted vaginal delivery, as well as the increased risk seen with antidepressant use. However we did not have data on known risks such as use of oxytocin during delivery, nor did we have any data on the severity of the underlying maternal psychiatric illness.
“Consequently, it is possible that the women who took antidepressants late in pregnancy were those with the most severe illness and it is this which is responsible for the increased risk of postpartum haemorrhage and not the antidepressant. Based on this study alone we do not recommend that women stop taking medication for depression during pregnancy, but are closely monitored in order to reduce the risk of any potential increased risk of bleeding as much as possible.”