Depression Rx Might Pose Smaller Risk in Moms-to-Be

Persistent pulmonary hypertension risk was small in babies of mothers who took antidepressants

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Many moms-to-be who take antidepressants may assume that weaning themselves off their meds is the safest thing for their baby, but the truth may not be so simple.

A new study found that the risk for a rare breathing issue in babies born to moms who take depression drugs may be lower than previously thought.

“Evidence from this large study of publicly insured pregnant women may be consistent with a potential increased risk of [persistent pulmonary hypertension of the newborn] associated with [the mother's] use of [antidepressants] in late pregnancy,” wrote lead study author and epidemiologist Krista F. Huybrechts, PhD, of Brigham and Women’s Hospital in Boston. "However ... the risk increase appears more modest than suggested in previous studies.”

Persistent pulmonary hypertension of the newborn (PPHN) is a serious disease in which a newborn's circulatory system fails. PPHN causes a decrease in blood to the lungs, making it hard for the baby to breathe. Ten to 20 percent of affected babies will not survive — and babies who do survive may face serious long-term issues.

"Doctors have to consider how safe it would be to take a depressed women off of her medication during pregnancy, and also think about the health of the baby," said Andre F. Hall, MD, an OB-GYN at Birth and Women's Care in Fayetteville, NC, in an interview with dailyRx News.

According to Dr. Hall, many antidepressants have recently been recategorized from category B (medications that are considered generally safe in pregnancy) to category C (medications that must be evaluated to see whether the benefit to the mother may outweigh the risk to the newborn).

“Simply put, if the mother is at risk of a significant depressive episode, suicidal thoughts or will significantly decrease her level of functioning if she is taken off the medication, it is generally considered to be the safer route to keep her on the medication,” Dr. Hall said.

Dr. Huybrechts and team looked at almost 4 million pregnant women on Medicaid between 2000 and 2015. They also looked at how many of these women filled prescriptions for antidepressants in the last 90 days of their pregnancy, and how many babies were diagnosed with PPHN in the first 30 days of life.

Dr. Huybrechts and team found that women not taking antidepressants had about 20.8 babies born with PPHN per 10,000 babies. This was compared with 31.0 babies with PPHN per 10,000 babies born to women taking antidepressants.

“In my experience in years of having women on antidepressant medications, I have yet to experience any unwanted medical effect to the child that we have been able to directly tie to the use of antidepressants,” Dr. Hall said.

This study was published June 2 in the journal JAMA.

The Agency for Healthcare Research and Quality and the National Institute of Mental Health funded this research. No conflicts of interest were disclosed.

Review Date: 
May 31, 2015
Last Updated:
June 3, 2015