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Psych Meds While Pregnant Triples Risk Of Early Birth

Nov 9, 2009 | Parker Waichman LLP

Last month we wrote that women who take antidepressants known as selective serotonin reuptake inhibitors (SSRI) during pregnancy may be more likely to experience premature birth than other women. Science Daily is now reporting that the likelihood of premature child delivery triples in pregnant women with a history of depression and who take certain psychiatric drugs.

The prior study was published in the Archives of Pediatrics and Adolescent Medicine and also found that babies born to women taking SSRIs were more likely to be admitted to an intensive care unit. Science Daily writes that researchers from the University of Washington, University of Michigan, and Michigan State University all found that the medication-depression combination, when present before or during pregnancy, was significantly associated to childbirth earlier than at 35 weeks' gestation.

The study looked at questionnaire results from 3,020 women who participated in the Michigan-based Pregnancy Outcomes and Community Health Study, said Science Daily. The questions involved issues with symptoms of depression that took place within a week of responding to the questionnaire, explained Science Daily. Women were also asked about their history of depression necessitating drugs such as tranquilizers or sleeping pills.

About 335 women—or 11 percent—delivered their babies preterm; of the women who suffered from depression during pregnancy, most—75 percent—suffered from depression, while 62 percent took medication in the first half of their pregnancy.

The study looked at “maternal depression, psychiatric medication use in pregnancy, and preterm delivery among women in five Michigan communities,” said Science Daily. The women were treated during pregnancy at one of 52 participating clinics between September 1998 and June 2004, were older than 15, had no diabetic history, and were 15 to 27 weeks pregnant, explained Science Daily.

"Women with depression face difficult decisions regarding the benefits and risks of using psychotropic medications in pregnancy," said Amelia Gavin, lead author and UW assistant professor of social work. "Therefore, a focus on disentangling medication effects and depression effects on mother and offspring health should be a major clinical priority." In general, preterm deliveries were prompted by complications that included, said Science Daily, “preeclampsia, poor fetal growth, or acute hemorrhage.”

As we previously wrote, popular SSRIs include Prozac, Paxil, Zoloft, Celexa, and Lexapro. SSRIs affect serotonin levels in the brain, a chemical neurotransmitter. Serotonin is produced in the brain on an ongoing basis and in response to pleasure-giving experiences, in a normally healthy system.

The prior study found that women who took SSRIs delivered their babies five days earlier than other women in the study, and were twice as likely to give birth prematurely. Babies born to these women were also more likely to have a five-minute APGAR score of seven or below. A baby considered healthy generally has a score of seven or higher. They also faced a higher risk of being admitted to the intensive care unit, and some showed signs of withdrawal. Also, babies born to mothers who have taken antidepressants, including SSRIs in the third trimester suffered complications from withdrawal, including difficulties with breathing, turning blue, seizures, changing body temperature, feeding problems, vomiting, low blood sugar, floppiness, stiffness, tremor, shakiness, irritability or constant crying. In many of these cases, tube feeding, help with breathing and longer hospitalization was needed.

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