To say that living with depression is difficult would be an understatement, but women who are trying to conceive or have already conceived may want to take a close look at the decision they have to make regarding their depression treatment. While it has long been thought that the exposure to stress hormones is bad for the developing fetus, there aren’t any conclusive studies that prove this theory. There are, however, studies that have linked the use of antidepressants to adverse effects on the fetus, some of which are serious.
According to research studies conducted on antidepressant use and pregnancy, antidepressant use during pregnancy increases a woman’s chance of miscarriage by 8 to 12 percent. Women who take antidepressants are also 60% more likely to experience a preterm birth if they do not have any symptoms of depression during pregnancy, and the risk is nearly double when they do.
“The complication rates with the use of these drugs aren’t low,” said Dr. Adam Urato, chair of obstetrics-gynecology at Metrowest Medical Center in Framinghamd, Mass, who also serves on the faculty at Tufts University of Medicine. He is a co-author on a recent study on the adverse effects of antidepressant use during pregnancy.
What’s more, Urato and his colleagues found that nearly a third of newborns exposed to antidepressants in utero develop a condition known as “newborn behavioral syndrome.” Infants who suffer from this condition experience jitteriness, feeding problems and inconsolable crying during the first few days or weeks of life. Some may even develop severe breathing problems and require a breathing tube.
“Newborn behavioral syndrome is very rare in babies who aren’t exposed to the drugs,” Urato said.
Usually, the condition goes away with time. However, study authors say that there could be long-term behavioral problems that have not been discovered yet. To back this theory, they cited animal studies that have found determined that antidepressant use during pregnancy leads to changes in brain development. They also pointed out that a human study suggested that antidepressant risk during pregnancy could increase a child’s risk of autism.
But not everyone is thrilled about the information presented in the recent study. Dr. Kimberly Yonkers, a psychiatrist and obstetrics-gynecology professor at Yale University says that certain women with severe depression could experience relapse – this could lead to even bigger issues for both mom and baby.
“I think it’s irresponsible to say that antidepressants don’t work, which is a minority view,” Yonkers said. “For them (women with severe depression), antidepressant use isn’t optional, just like diabetics or epileptics can’t stop taking their medications during pregnancy. This isn’t a one-size-fits-all deal.”
Yonkers also says the risk of preterm birth isn’t as bad as some studies have made it out to be. She conducted a study earlier this year on it and found that women who took the drugs gave birth three to five days earlier, on average, than those that did not.
The American College of Obstetricians and Gynecologists and the American Psychiatric Association issued a joint statement about antidepressant use during pregnancy. Presented to the public three years ago, the advisory says women who take antidepressants but have mild or no symptoms for six months or longer should consider tapering off their medication before becoming pregnant. However, they also stated that “medication discontinuation may not be appropriate in women with a history of severe, recurrent depression.”
Alice Domar, a psychologist who heads the Domar Center at Boston IVF worked with Urato on the study. She fully acknowledged that antidepressants may sometimes be needed to prevent suicidal tendencies or a relapse that could keep a mom-to-be in bed, and she doesn’t dispute the recommendations.
“We’re not talking about those with severe depression,” Domar said.
But Domar also says that the majority of the patients who walk through the doors of her infertility clinic taking antidepressants suffer from only mild to moderate depression. She says that these patients could receive the same benefits from alternative methods like cognitive behavioral therapy or relaxation techniques like yoga, without all of the risks that antidepressants pose to their developing babies.
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