By Korin Miller
New research has found that taking most common antidepressants during pregnancy isn’t linked to future behavioral or cognitive issues in children. The research is being applauded by mental health experts and ob/gyns, who say it can help expectant mothers make better decisions around their mental health care during pregnancy.
The study analyzed data from more than 145,000 women who took antidepressants during pregnancy and their children in the U.S. for up to 14 years. The researchers found that antidepressant use and exposure during pregnancy wasn’t linked with a slew of potential health conditions in children, including:
-autism spectrum disorder
-attention-deficit/hyperactivity disorder
-specific learning disorders
-developmental speech/language disorders
-developmental coordination disorders
-intellectual disabilities
-behavioral disorders
The researchers also noted that “results were generally consistent across antidepressant medication classes, commonly used individual drugs, and gestational exposure windows.”
More than 13% of adults in the U.S. use antidepressants, according to data from the Centers for Disease Control and Prevention (CDC), and use is typically higher in women (nearly 18%) than men (8%).
Previous data on antidepressant use has had mixed results—and has been a little controversial. Here’s what you need to know.
Doctors applaud the study.
“We have been waiting for a study such as this,” says Thea Gallagher, Psy.D., a clinical assistant professor of psychology at NYU Langone Health and cohost of the Mind in View podcast. Gallagher points out that pregnant women who struggle with anxiety and depression have not had robust data to consult when making decisions about continuing with their antidepressants or starting new medication.
“This will give women a lot of security around continuing their medication, because many people feel that they’re stuck between a rock and a hard place with antidepressant use during pregnancy,” she says.
Hillary Ammon, Psy.D., clinical psychologist at the Center for Anxiety & Women's Emotional Wellness, points out that “data and facts can provide a sense of comfort and more certainty” around any topic, especially when it comes to making decisions during pregnancy. “Previously, there was data showing a relationship between the use of antidepressants during pregnancy and neurodevelopmental disorders,” she says. “Now, there are newer findings showing that this may not be the case, and instead, other variables may have led to neurodevelopmental disorders, such as environment and genetics.”
Ammon says it’s “monumental” to have these findings. “Instead of doctors simply providing reassurance that their patients will be safe during pregnancy, they can now provide data to back their statements,” she says. “Pregnancy is filled with uncertainty and scary thoughts, like, ‘What if this choice harms my baby?’ Individuals will often not know the impacts of most choices until they give birth or their child gets older. It can feel risky taking medication that could impact the baby in the womb.”
Women’s health expert Jennifer Wider, M.D., calls the findings “very reassuring for women who need medication support for mental health conditions during pregnancy.”
She continues, “So many women are worried about harming their babies in utero and often have to choose between what they think comes down to their own mental health vs potential harm to the baby. Having hard data that shows that antidepressants are not linked to autism, ADHD, developmental speech and language delays, and other related disabilities should allay many of these fears.”
What data suggests about antidepressant use in pregnancy
Past data about the use of antidepressants in pregnancy has found some link between using the medication and developmental complications in children, such as autism and ADHD.
But the data has mostly been observational and hasn’t controlled for other factors that could raise the risk of developmental, cognitive, or behavioral issues. “It’s important to look at data in context and control for confounding variables,” Gallagher says. Meaning, there are other risk factors for behavioral and developmental complications in children that pregnant patients taking medication may have had, and some of these studies haven’t accounted for them.
Research has also linked certain antidepressants—specifically, fluoxetine and paroxetine—with birth defects. The CDC notes that fluoxetine and paroxetine were linked to certain birth defects, including heart defects, skull defects, and abdominal wall defects. However, there was no confirmed link between sertraline (Zoloft), a commonly-used SSRI, and any birth defects in this particular study.
But it’s important to point out, per the CDC, that despite the increased risk of certain birth defects from taking some SSRIs, the actual risk of a birth defect in babies born to women taking one of these medications is low. “Because these specific types of birth defects are rare, even doubling the risk still results in a low absolute risk,” the CDC notes. “For example, the risks for heart defects with obstruction of the right ventricular outflow tract could increase from 10 per 10,000 births to about 24 per 10,000 births among babies of women who are treated with paroxetine early in pregnancy.”
What to do if you struggle with anxiety and depression during pregnancy
It’s important to have a conversation with your doctor and mental health professional, Ammon says. “I like to remind women and birthing individuals that good mental health is just as important as good physical health during pregnancy,” she says. “We often see more adverse outcomes when an individual is struggling with anxiety or depression in pregnancy versus taking medication to treat anxiety and depression in pregnancy.”
If you can, she also recommends trying to find a provider who specializes in perinatal mental health.
And, if you have concerns about medication you take or are prescribed, Ammon recommends contacting your ob/gyn’s office. “They are there to help you and ensure you have a safe and healthy pregnancy, as well as reduce worries,” she says.
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