Antidepressants are prescribed to millions of patients each year. However, they are also associated with a number of fatal birth defects. It is encouraged that pregnant women with mild depression avoid taking antidepressant drugs due to the severe risk of harm to their developing children. In many cases, the debate is difficult for pregnant women who suffer medical depression.
The most common types of antidepressants on the market today are selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRI). These two types of antidepressants function by affecting different natural chemicals in the body. However, evidence suggests that both types of antidepressants are associated with birth defects when taken during pregnancy.
A number of children born to antidepressant patients experience heart defects. These defects are believed to increase when the antidepressant is taken during the pregnancy’s first trimester. Many newborns experience septal heart defects, or malformations of the wall that separates the right and left sides of the heart. The British Medical Journal reports that infants whose mothers took more than one SSRI during early pregnancy were four times more likely to develop septal heart defects.
Persistent Pulmonary Hypertension of the Newborn
Persistent pulmonary hypertension of the newborn (PPHN) is a documented antidepressant birth defect. PPHN occurs when the infant’s lung arteries remain constricted after birth. This limits blood flow to the lungs. In turn, the amount of oxygen in the bloodstream is limited as well. Newborns with PPHN often need mechanical ventilation and intubation in order to survive. Despite these medical treatments, it is estimated that up to 20 percent of PPHN victims do not survive.
Respiratory distress syndrome (RDS) is a breathing disorder that occurs when a newborn’s lungs are not fully developed. RDS most commonly occurs in premature infants. In healthy infants, the lungs are coated with a substance called surfactant. Surfactant lubricates the lungs to help keep them open after birth. RDS causes insufficient production of surfactant.
Without an adequate amount of surfactant, the infant has difficulty breathing. In extreme cases, the infant’s lungs collapse and his or her body does not receive enough oxygen. If the infant fails to receive immediate medical attention, he or she may develop brain or organ damage.
A number of studies examine the long-term effects of antidepressant use during pregnancy. These studies include cognitive and emotional development of the children born to antidepressant patients. The Archives of General Psychiatry published a study on this topic in 2011. The study assessed first trimester antidepressant use and its relationship with autism spectrum disorders (ASD). While the risk factor was generally low, the study noted an association in 3 percent of cases.
Studies on Antidepressant Birth Defects
In November 2012, a study on antidepressant birth defects was published in the journal Human Reproduction. The study found that pregnant women taking SSRIs may be at higher risk for pregnancy complications that include birth defects, miscarriage, and preterm birth.
Findings on antidepressant birth defects differed in the Journal of the American Medical Association’s study. The study analyzed data on 1.6 million women residing in Nordic countries. Among these women, roughly 30,000 had filled an SSRI prescription while pregnant. The study revealed higher rates of infant death and stillbirth. However, experts claim that these higher rates were attributed to the fact that the patients had higher rates of tobacco smoking, older age, hypertensive disease, and diabetes.
While the study is believed to be one of the most effective and thorough, the results have received criticism. MetroWest Medical Center’s chairman of obstetrics and gynecology argues that the study observed patients based on dispensed drugs. This does not necessarily mean that all patients took the drugs. Often, there can be a large difference between the two statistics.