There are more premature babies born these days than there were 20 years ago, and there are more pregnant women taking antidepressants. Researchers recently looked to see if there was a link between the two.
Researchers have found that taking antidepressants, particularly during the third trimester, is associated with an increased chance that a woman’s baby will be born early.
The research was led by Krista Huybrechts, PhD, of the Division of Pharmacoepidemiology and Pharmacoeconomics at Brigham and Women’s Hospital in Boston.
The researchers conducted a systematic review and meta-analysis looking for research on the topic of pregnant women using antidepressants and premature births from 1993 through September of 2012.
They used 41 studies that met their criteria; they included pregnant women who were exposed to antidepressants at some point in their pregnancy and compared them to a comparison group, and included rates of preterm births. The studies included anywhere from 44 to 1,618,255 participants.
All of the studies except for one considered premature infants as those born before 37 weeks. One study included babies born before 36 weeks.
Babies born prematurely are more likely to be born with health issues and are higher risk for heath problems as they grow.
The researchers found that women who took antidepressants into their third trimester had up to double the risk of having a baby born early compared with women who did not take antidepressants.
There was no increased risk based on mothers taking antidepressants in their first semester, the researchers found, and while there is a risk in the second trimester, the highest risk is in the third.
There could be arguments that a woman who is depressed may have other behaviors that increase her risk of giving birth prematurely, such as increased smoking, poor nutrition or increased alcohol consumption, the researchers noted. However, they did not feel these could explain all the association, and noted that other studies have found antidepressants use increased the risk for premature births as well.
The researchers suggest that pregnant women who are depressed may wish to try psychotherapy or exercise before relying on medication, but noted that a physician has to assess what is best for a pregnant woman on a case by case basis, depending on how depressed the woman is and what might help.
“Pregnant women with depression need proper treatment and our results should not be seen as an argument to ignore depression in these patients,” said Dr. Huybrechts in a press release. “These drugs may be necessary in some pregnant women with severe depression in whom other approaches are inadequate. However, for many others, non-drug treatments, such as psychotherapy, will help, and aren’t associated with complications like preterm birth.”
“Counseling of pregnant women must take into consideration the clinical circumstances of a given patient, the strength of the available evidence on the risks and benefits (i.e., avoidance of risks associated with untreated depression), and alternatives to medication use during pregnancy,” the researchers wrote.
This study appears in the March 26 edition of PLOS ONE.
The authors acknowledged no competing interests.