Antidepressant use in pregnant and postpartum women

Annu Rev Clin Psychol. 2014;10:369-92. doi: 10.1146/annurev-clinpsy-032813-153626. Epub 2013 Dec 2.

Abstract

Women in their reproductive years are at risk of experiencing depressive and anxiety disorders. As such, it is likely that pregnant women will undergo treatment with antidepressants. We review the risk of adverse birth outcomes and neonatal complications subsequent to antidepressant use in pregnancy. An inconsistent literature shows that antidepressant exposure is associated with shortened gestations and diminished fetal growth; these effects are small. Transitory neonatal signs are seen in some neonates after exposure to antidepressants in utero. No specific pattern of malformations has been consistently associated with antidepressants, with the possible exception of paroxetine and cardiac malformations. There is inconclusive evidence of a link between antidepressants in late pregnancy and persistent pulmonary hypertension in the newborn. Extensive study finds that antidepressants cannot be considered major teratogens. It is likely that confounding factors contribute to a number of the adverse effects found to be associated with antidepressant use in pregnancy.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Antidepressive Agents / adverse effects*
  • Antidepressive Agents / therapeutic use
  • Depression, Postpartum / drug therapy*
  • Depressive Disorder / drug therapy*
  • Female
  • Heart Defects, Congenital / chemically induced
  • Humans
  • Infant, Newborn
  • Paroxetine / adverse effects
  • Persistent Fetal Circulation Syndrome / epidemiology
  • Pregnancy
  • Pregnancy Complications / drug therapy*
  • Prenatal Exposure Delayed Effects

Substances

  • Antidepressive Agents
  • Paroxetine