As if the unrelenting melancholy of depression isn't bad enough, deciding whether or not to take (or stay on) antidepressants during pregnancy is one of the hardest decisions a mother can make. On one hand, high levels of stress hormones may have harmful effects on your baby. On the other, antidepressants may have their own consquences, says a new review published in the journal PlOS One.
Researchers looked at 41 published papers that had one thing in common: antidepressants and pregnancy. They found that taking antidepressants while pregnant is associated with an increased risk of preterm birth. What's more, since some of the studies controlled for depression itself, researchers believe the medication is to blame.
But roughly 20 percent of women suffer from persistent depression or anxiety during pregnancy—debilitating conditions which, according to mounting research, can have lasting physical and mental consequences for a developing baby.
Studies show that 8 percent to 10 percent of pregnant women now take antidepressants, most commonly, selective serotonin reuptake inhibitors (SSRIs). And in some cases these medications are a wise choice, doctors and researchers say. But with numerous studies showing a potential link between SSRIs and fetal cardiac defects, and the risk of premature birth, many women with mild-to-moderate depression are looking toward drug-free alternatives—and finding success.
The Dangers of Doing Nothing
With a baby on the way, many women think their only options are to take medication or suffer through any mental health issues for the sake of their babies’ health.
“Women often say, ‘let me just get to the end of this pregnancy,’ and don’t try any treatments for their depression. But waiting it out comes with its own serious risks,” says Sona Dimidjian, Ph.d.
Clinically depressed moms-to-be (those who have symptoms most of the time on most days for two weeks or longer) tend to have poorer diets and sleep habits, are less likely to take their prenatal vitamins and attend doctor visits, and are more likely to smoke or drink, studies show.
Mounting research also suggests that exposure in the womb to excess stress hormones, such as cortisol, can influence the development of the baby’s “fight or flight” stress- response system and possibly impair the growth of neurons.“There’s increasing data to suggest that when you’re depressed during pregnancy, you’re creating a different in utero environment that could affect the baby’s brain development,” explains Catherine Monk, Ph.D., an associate professor in psychology and obstetrics and gynecology at Columbia University.
For some women, perinatal depression seems to arise out of nowhere, the likely result of hormonal shifts and new life stresses. For others, pregnancy may trigger a recurrence or worsening of previous problems. Yet only a fraction of pregnant women start treatment and as many as 50 percent taking antidepressants before conception stop taking them after getting pregnant.