Researchers are unsure of the effects antidepressant use during pregnancy can have on unborn babies—but it looks like congenital heart defects are not related.
The safety of taking antidepressants while pregnant has been discussed extensively. On the one hand, there's been fear that these drugs could cause autism. On the other, we've seen research to indicate that the risk of antidepressants causing birth defects is low.
Now we have more evidence to suggest that antidepressant use might be safe for pregnant women: A recent study from University College London analyzed data from over 200,000 women and their children between 1991 and 2001 and found what appears to be no link between antidepressant use during pregnancy and congenital heart defects.
What leads to heart defects?
An abstract for the study points out that this research might seem to contradict previous studies, which found a link between selective seratonin reuptake inhibitors (SSRIs), which are the most commonly prescribed antidepressants for pregnant women, and congenital heart anomalies. However, the study authors also point out that these previous studies did not take other factors into account.
The study did find that certain traits can make women more likely to give birth to children with heart defects: Diabetes, obesity and drug and alcohol abuse were all factors that could up a mother's risk of giving birth to a child with this issue. All of these factors were found to be more prevalent among women who used antidepressants—this relationship could certainly skew our assumptions about the role antidepressants can play, but this study attempts to set the record straight about antidepressant use's effects.
Lead author Irene Petersen, Ph.D., says: "Women often receive conflicting messages on whether they should continue taking antidepressants during pregnancy and many women may discontinue antidepressants in pregnancy because they fear adverse effects on their unborn child."
The researchers looked at several groups of women: one group was exposed to SSRIs before pregnancy; one received them during pregnancy; one received other antidepressants during pregnancy and the final group received no antidepressants before or during pregnancy. According to the results, the risk of congenital heart defects being passed to the child was less than 1 percent across all groups.
"Our research adds to the ongoing debate on whether these drugs cause congenital heart anomalies, and we have found no evidence to any such effect. However, health care professionals should counsel women on other risks contributing to congenital heart anomalies in children such as age, weight, diabetes, alcohol problems and illicit drug use," Petersen says.
The researchers found that 20 percent of women who were prescribed antidepressants during pregnancy were smokers, while 35 percent abused alcohol and drugs. Issues with drugs and alcohol were ten times more common in women who used antidepressants—and this link can certainly explain why we previously thought antidepressants were to blame, causing four out of five women stopping use when they become pregnant.
"We know from a US study that up to 70 percent of pregnant women, who stop an antidepressant, have a recurrence of depression," Petersen says, "which also can have major consequences. So it is important to consider both the pros and cons before women stop taking antidepressants during pregnancy."