Antidepressants linked with preterm birth

Using antidepressant drugs during pregnancy may be related with an increased risk of preterm birth and consequently a lower fetal age at delivery. Depression is common during pregnancy, and symptoms may occur more frequently during pregnancy than in the postpartum period. Depression during pregnancy and just after delivery has been associated with low maternal weight gain, increased frequency of cigarette, alcohol, and substance use, and ambivalence about the pregnancy. However, it is the use of the antidepressant drug, rather than depression, during pregnancy that seems to increase the risk of preterm birth and affect the infant gestational age at birth. To further investigate the effects of maternal depression and antidepressant drug use on fetal age and risk of preterm birth, researchers from the University of California, Los Angeles studied 90 pregnant women. The women were divided into three groups: 49 women had major depressive disorder and were treated with antidepressant medication for more than 50 per cent of their pregnancy; 22 women had major depressive disorder and were briefly treated or not treated with antidepressants during pregnancy and a comparison group of 19 healthy pregnant women. The average fetal age at birth was 39, 39 and 40 weeks in the three groups, respectively. The groups also differed in the rates of preterm birth (14 per cent, 0 per cent and 5 per cent, respectively) and rates of admission to the special care nursery (21 per cent, 9 per cent and 0 per cent, respectively). No significant between-group differences were observed in actual birth weights or health assessment scores of the newborns. The findings suggested that the presence of depression per se during pregnancy did not adversely affect the outcome. The two groups of women with depression — those who were treated with antidepressants and those who were not — had similar degrees of depression and anxiety during pregnancy. Thus, the results indicate that antidepressant use, rather than mild-to-moderate depression, is associated with an increased risk of preterm birth and lower fetal age.