The relationship between maternal antidepressant use and fetal health has long been of concern to both the women’s health and pediatrics communities. Research into how antidepressants affect a growing fetus has led to some actionable information on which antidepressants are safest and if and how certain women can stay on antidepressants while pregnant. However, given the challenges of conducting randomized controlled studies on pregnant women, our understanding of the specific impact of antidepressants on fetal development is limited.

New results published in JAMA Psychiatry suggest that some antidepressants may lead to specific birth defects. Based on previous work that has shown that selective serotonin reuptake inhibitors (SSRIs) and venlafaxine may increase the likelihood of birth defects, the authors of this latest study aimed to clarify which specific medications may lead to these types of adverse outcomes.

Physicians along with researchers evaluated data from more than 42,000 mothers. More than 30,000 of these mothers had infants who had birth defects. They found that 1,562 of the mothers of those with birth defects – or 5.1% – used antidepressants early in their pregnancy. By comparison, 467 – or 4.1% – of those whose infants did not have birth defects used antidepressants during this part of pregnancy.

While both SSRIs and venlafaxine were associated with birth defects, the associations mainly only persisted after underlying conditions were accounted for in the case of venlafaxine. SSRI associations with, for instance, congenital heart defects, were attenuated after controlling for underlying conditions.

These results offer new insights into how antidepressants may affect fetal health when taken by pregnant women. However, there is also significant evidence highlighting the risks to the fetus when a pregnant woman is depressed and untreated. More research is therefore needed to help delineate the specific ways that women can maintain both their and their childrens’ health when they suffer from depression during pregnancy.

Reference

Anderson, K.N. (2020). Maternal use of specific antidepressant medications during early pregnancy and the risk of selected birth defects. JAMA Psychiatry,  doi:10.1001/jamapsychiatry.2020.2453.