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Antidepressants in Pregnancy

  • Sophie GrigoriadisEmail author
  • Miki Peer
Chapter

Abstract

Scientific evidence regarding whether potential adverse effects for the offspring or mother exist following antidepressant exposure during pregnancy continues to evolve and remains conflicting at times. Diverse outcomes are confounded by many variables limiting interpretation of results, the major of which is the severity of the psychiatric illness which itself has adverse effects on similar outcomes as those studied for antidepressants. These medications do not appear to affect women’s ability to get pregnant, nor do they lead to spontaneous abortion. They are not major teratogens, and recent data do not support an association with cardiac anomalies after accounting for confounds overall. Exposure in utero is associated with a small effect on gestational age, low birth weight, preterm birth, and APGAR scores. PNAS has been consistently reported, but typically the signs are transient. Whether there is an increased risk for autism spectrum disorders is uncertain as well as for ADHD. Antidepressants appear to increase the risk for postpartum hemorrhage, but with other negative maternal outcomes, the association is not clear nor is the clinical significance. Antidepressants other than SSRIs have been less researched and sample sizes are small, but typically the same issues are present.

Keywords

Antidepressants Serotonin reuptake inhibitors Serotonin–norepinephrine reuptake inhibitors Pregnancy Adverse outcomes Maternal outcomes Congenital malformations Delivery outcomes Neonatal outcomes Neurodevelopmental outcomes Childhood outcomes 

Notes

Acknowledgement

Competing Interests: SG has received other fees from Allergan, personal fees from Pfizer, other fees from Sage, and personal fees from Bristol-Myers Squibb, outside the submitted work, and reported no other relationships or activities that could appear to have influenced the submitted work. MP reports no financial relationships with any organizations that might have an interest in the submitted work in the previous 3 years and no other relationships or activities that could appear to have influenced the submitted work.

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Psychiatry, Women’s Mood and Anxiety Clinic: Reproductive Transitions, Sunnybrook Health Sciences CentreUniversity of TorontoTorontoCanada
  2. 2.Evaluative Clinical Sciences, Sunnybrook Research InstituteSunnybrook Health Sciences CentreTorontoCanada

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