New research posted in the July 8th issue of the medical journal ‘The BMJ’ finds more evidence of a potential association with use of antidepressants during early pregnancy and an increased risk of birth defects. This isn’t the first time such a connection has been considered, however the recent study suggests stronger ties between certain brands of drugs and the effects on an unborn child.
The investigation looked at statistics from nearly 10,000 mothers, and almost 18,000 mothers of children with birth defects, all of which were born between 1997 and 2009. The study focused primarily on drug use within the first three months of pregnancy, which is reportedly when the pharmaceuticals are thought to do the most damage. Nothing has been proven however, and experts urge mothers not to get off their medication just yet.
“Depression can be very serious, and women should not suddenly stop taking their medications. Women should talk to their health care providers about available options, ideally before planning a pregnancy,” said Jennita Reefhuis, author of the study and epidemiologist at the U.S. Centers for Disease Control and Prevention.
“The key here is not to tell pregnant women what to do. Instead, it’s crucial to make full information available to them,” says Dr. Adam Urato. “Counsel them about drug exposures in pregnancy, and allow them to make the best choice for themselves.”
Interestingly, the study also concluded that some antidepressants were more harmful than others. For example, some birth defects – including issues with the heart, brain, skull, and abdominal wall – occurred ‘two to three times more frequently with mothers who took paroxetine (Paxil) and fluoxetine (Prozac) during early pregnancy’, while sertraline (Zoloft) held no relation with five birth defects that it had previously been linked to.
“A woman’s chance of having a child with the heart defect we described is about 10 per 10,000. Our results suggest that if she took paroxetine [Paxil], that risk could increase to 24 per 10,000,” explained Reefhuis.
Fortunately, Zoloft is already a common antidepressant, with approximately 40% of women using it in early pregnancy. However, experts are unsure if this difference in the drugs’ effects is just a ‘statistical fluke’ or not.
Regardless, the relationship between such medication and birth defects has been a hard one to pin down. There are many other factors that we simply may not know or didn’t document well enough in the studies that could cause the deformities, with Reefhuis suggesting that depression itself being one of them. She notes that birth defects are possible no matter what cautions the mother takes; one in 33 infants are born with one.
Urato seems to think that the drugs are a crucial aspect though, saying “Chemicals have consequences, and chemicals going into a developing embryo and fetus are going to have consequences.” This makes it very difficult to accurately diagnose the ramifications from taking pharmaceuticals, as pregnant women who are depressed need the appropriate care, however he stresses that “we should be very concerned about the widespread use of these medications in pregnant women like we’re seeing.”