Anti-Depressant Birth Defect Risk

New York, NYPregnancy is often portrayed in the media as a joyful rite-of-passage for young women. Unfortunately, this isn't always the case. As a May 7, 2007 press release from the American College of Obstetricians and Gynecologists (ACOG) points out, impending motherhood is sometimes associated with wild mood swings and despondency.

"Women in their childbearing years account for the largest population of Americans with depression," states the ACOG press release. "Depression is one of the most common complications during pregnancy and the number one risk factor for post-partum depression; approximately one in 10 women will have major or minor depression sometime during pregnancy and the postpartum period."

Herein lies the problem: while depression is common among expectant mothers, the medications that combat it aren't particularly good for developing fetuses.

"Untreated depression during pregnancy has been linked to higher rates of miscarriage, stillbirths, premature deliveries, intrauterine growth restriction and low birth weight babies," states the ACOG.

At the same time, Selective Serotonin Reuptake Inhibitors (SSRIs—the name given to the new series of antidepressants) can have their own negative effects.

"Exposure to SSRIs late in pregnancy has been associated with short-term complications in newborns including jitteriness, mild respiratory distress, excessively rapid respiration, weak cry, poor muscle tone and admission to the neonatal intensive care unit," states a December 1, 2006 press release from ACOG.

The ACOG doesn't suggest that pregnant women completely stop taking SSRIs. The organization does urge caution, however, for anyone thinking of mixing motherhood and medication.

A study published in the February 2006 edition of The New England Journal of Medicine, examined the role of SSRIs in causing Persistent Pulmonary Hypertension (PPHN) in newborns. PPHN is a serious disorder that causes the blood vessels in the lungs to constrict. Oxygen is thus unable to reach the bloodstream. In worst-case scenarios, PPHN can be fatal.

"Between 1998 and 2003, we enrolled 377 women whose infants had PPHN and 836 matched control women and their infants," states the Journal's review of the study. Researchers found that, "Fourteen infants with PPHN had been exposed to an SSRI after the completion of the 20th week of gestation, as compared with six control infants."

Put more plainly, the "study showed that infants born to mothers who took SSRIs after the completion of the 20th week of gestation were six times more likely to have PPHN than infants who were not exposed to antidepressants during pregnancy," states a July 2006 physician information sheet issued by the U.S. Food and Drug Administration.
And what do the makers of SSRI drugs have to say about pregnant women taking their products?

Not much, as it turns out.

Prozac.com, for example, is a website managed by pharmaceutical giant Eli Lilly (makers of Prozac).

The site contains a list of people who should not take Prozac. The list includes patients with allergies or cross-medication problems, but doesn't mention expectant mothers. The site urges women taking Prozac who are pregnant or want to become pregnant to consult their physician, but that's about it.

In the meantime, pregnant women have to decide: do they quit taking SSRIs and run the risk of depression or continue with their medication and run the risk of incurring birth defects in their unborn children?