Taking antidepressants during pregnancy does not increase a woman’s risk for preterm birth, scientists at the March of Dimes Prematurity Research Center (PRC) at the University of California, San Francisco (UCSF), found in a recent collaboration with the KI Research Institute in Israel.
However, the study, published in npj Women’s Health, found that preterm birth risk did increase by 10% for women with a history of depression who didn’t take antidepressants during pregnancy, compared to those without a history of depression.
The study findings still need to be validated in a larger trial.
The paper’s authors, including senior author and UCSF PRC Principal Investigator Dr. Marina Sirota, concluded that the effect of selective serotonin reuptake inhibitors (SSRIs)—the most widely used type of antidepressants and the ones spotlighted in the study—on preterm birth risk was benign, and that women wanting to go on SSRIs should be confident the medication won’t impact birth timing.
“Our findings indicate that the concern of [preterm birth] should not affect the clinical decision of medical treatment for pregnant women suffering from depression, since antidepressant treatment by itself does not increase the risk of [preterm birth,]” they wrote in the study.
The retrospective study pulled data from Electronic Health Records (EHRs) belonging to 176, 866 patients from the UK between 1996 and 2019.
The paper sought to answers two questions: first, did taking SSRIs increase risk of preterm birth, and second, did a history of depression increase risk of preterm birth?
For the first question, the team compared women who continued to take SSRIs during pregnancy and those who stopped SSRIs before pregnancy. They found both groups had the same risk of preterm birth.
For the second question, the team compared the pregnancy outcomes of two groups of women not on SSRIs: those with and without a history of depression. The data was apparent—those with a history of depression had a 10% higher risk of preterm birth than those without a history.
Dr. Guy Amit, a KI Institute senior researcher who was first author on the study, said the report’s conclusion was clear.
“The main message of the paper is that an increased risk of [preterm birth] is associated with depression, but not with the antidepressant treatment,” he wrote in an email to March of Dimes.
The study adds to the well-established and growing body of scientific literature that shows minimal overall risk to mom and baby from taking antidepressants during pregnancy. This is especially true when compared to the risk of untreated mental health conditions in pregnancy.
Pregnancy, which is seen as a joyful experience, can also be a time of stress for pregnant people, and a history of anxiety or depression prior to pregnancy is a risk factor for heightened stress during pregnancy, as well as for postpartum depression (PPD).
But because research on the topic of antidepressants in pregnancy have had inconsistent findings, fear, and uncertainty about the drugs cause many women to stop taking their medication once they learn they’re pregnant, or to resist beginning treatment in the middle of pregnancy despite needing to.
According to The Center for Women’s Mental Health at the Massachusetts General Hospital, which specializes in perinatal mental health, avoiding treatment can have devastating effects for mom and baby, including insomnia, severe disruptions in mood, psychosis, and even suicide, among others. Maternal stress has also shown to have negative effects on babies in utero.
According to 2015-2018 data from the US Centers for Disease Control (CDC), an estimated 17.7% of adult women take antidepressants for the treatment of depression and anxiety, with about 7% of women taking them during pregnancy.
Other co-authors from the UCSF PRC include Alice Tang, Brian Le, Jackie Roger, Sarah Woldemariam, Idit Kosti, and Tomiko Oskotsky.