Medicine during pregnancy

Medicine during pregnancy
By Sandy Hemphill, Contributing Writer, BabyMed

A class of drugs known as selective serotonin reuptake inhibitors (SSRIs) brings relief to many people experiencing depression and anxiety but some doctors are hesitant to prescribe them for pregnant women and some pregnant women hesitate to take them. It is almost impossible to study a drug’s therapeutic effects during pregnancy in a clinically controlled trial and SSRIs are no exception. A growing number of less-rigidly controlled studies, however, indicate it is probably healthier for mothers and their babies if mom takes SSRIs during pregnancy rather than go untreated.

Types of Scientific Drug Studies

Standard protocol for a clinical trial requires giving some study participants a specific dosage of the drug under study but withholding it from others who get placebo (fake) drugs instead, with neither the participants nor the researchers knowing who gets what until the participant portion of the study is over. For reasons of legality, morals, ethics, and other concerns, these studies are rarely, if ever, conducted on pregnant women.

Less rigid forms of scientific study include anecdotal studies in which the study participants report the extent of their actions that affect the study. Their participation is not strictly controlled so compliance isn’t always 100%; people tend to say what they expect the listener wants to hear. Analytical studies compare medical records and patient outcomes to identify trends.

Norwegian Institute of Public Health

This analytical study from Norway assessed the motor skill development of 51,404 3-year-old Norwegian children who are part of a long-term study of mothers and their children. Of this group, 159 mothers used SSRIs for an extended length of time during pregnancy. The researchers found a slight delay in the fine and gross motor skills of the children whose mothers took SSRIs but the degree of impairment was so slight and the number so small that there was no need to suggest altering prescribing protocols.

University of Adelaide, Australia / Study #1

This analytical study involved review of medical records of 49,000 pregnant Danish women to see how taking antidepressant medications during pregnancy affected their children’s behavior at age 7. Of this group, 210 mothers took antidepressants, some of which were SSRIs, and 231 took nothing for depression during pregnancy.

The children exposed to antidepressants during gestation were no more likely to experience behavioral problems than children of mothers who did not experience depression during pregnancy. The children of mothers whose depression was not treated, however, were more likely to exhibit problem behaviors, peer problems, hyperactivity, and inattention.

University of Adelaide, Australia / Study #2

The same research team examined links between antidepressants taken during the third trimester and postpartum hemorrhage (excessive bleeding during the first 24 hours after childbirth). The research revealed an 11% risk of postpartum hemorrhage in women who were not depressed and women with untreated depression. The women taking antidepressants, however, faced an increased risk (16%) of postpartum hemorrhage and anemia.

Full details of all three studies were recently published in An International Journal of Obstetrics and Gynaecology (BJOG).

Sources:

  1. "New studies show no long term effects of antidepressant use during pregnancy, but risk of significant blood loss during childbirth is increased." BJOG. Wiley-Blackwell, 16 Sept. 2015. Web. 23 Sept. 2015.
  2. "Depression: What Is Depression?." NIH / National Institute of Mental Health. US Department of Health and Human Services, n.d. Web. 23 Sept. 2015.