June 27, 2007 (Insidermedicine) Pregnant women who take SSRI antidepressants during pregnancy are not at higher risk of having a baby with a birth defect, according to research published in the New England Journal of Medicine.

An estimated 10 to 15% of women will experience major depression, with the highest risk being during the childbearing years. Selective serotonin-reuptake inhibitors, or SSRIs, are the most commonly used class of antidepressants in pregnancy and in general. Recent studies have suggested that SSRI use during pregnancy may be associated with birth defects, particularly congenital heart defects.

To assess the risk, researchers analyzed data from more than 9,600 infants with major birth defects and more than 4,000 healthy infants over a 5 year period. The mothers were questioned regarding their use of medications before and after pregnancy, including the use of three specific SSRIs – Prozac, Zoloft, and Paxil.

They found that 3% of mothers reported using an SSRI at some point one month before to three months after conception. There were no significant associations between the use of SSRIs and congenital heart defects or most other types of birth defects. An increased risk of rare defects such as premature fusion of the bones that make up the skull was noted in those who used SSRIs. 

It is important to remember that stress or depression during pregnancy may negatively  affect the health of the baby, and women with serious depression who discontinue antidepressants may adversely affect themselves and their and babies.

While further studies are needed to provide additional guidance, it is recommended that pregnant women on SSRIs be assessed to make sure the risks and benefits of antidepressant use benefit both the mother and baby.

For Insidermedicine I'm Dr. Susan Sharma.