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Antidepressant use during pregnancy does not affect child

While there is an increased risk for postpartum hemorrhage, researchers in three new studies said the potential consequences of untreated depression are worse.

By Stephen Feller

WASHINGTON, Sept. 16 (UPI) -- Three new studies show the use of antidepressants by pregnant women does not have neurodevelopmental or behavioral effects on their children.

The studies showed that selective serotonin reuptake inhibitors, or SSRIs, carry an increased risk for postpartum bleeding, however researchers said depression poses a greater risk for women and their children, which requires it to be addressed.

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"These studies add to a growing body of evidence about the safety of taking antidepressants during pregnancy," John Thorp, deputy editor-in-chief of the International Journal of Obstetrics and Gynecology, which published all three of the studies, said in a press release. "While there are some increased risks, the evidence so far seems to be that the risks of untreated depression outweigh the risks of taking them."

The Norwegian Institute of Public Health conducted a study on motor development of children whose mothers were treated with SSRIs by analyzing data on 51,404 children from the Norwegian Mother and Child Cohort Study, looking at the effects of SSRI use on motor skill development at age 3.

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The researchers found 381 mothers had used SSRIs while pregnant, and 159 of them were treated with the drugs for a prolonged period. While exposure to SSRIs was weakly associated with a delay in motor development, researchers wrote in the study that the association was "not to the extent that the delay was of clinical importance."

A group of researchers at the University of Adelaide in Australia conducted a review of data on 49,000 women in the Danish National Birth Cohort to find the effects of SSRI use on children's behavior by age 7. The study found that untreated depression in pregnant women was associated with increased risk for problem behavior.

In the 210 children whose mothers were treated for depression with SSRIs there was no increased risk for behavioral problems, as compared with 231 children who were more likely to have behavior issues such as hyperactivity, inattention, and peer problems.

The same group of Australian researchers also found in a separate study that mothers are more likely to experience bleeding after giving birth if they were treated with SSRIs.

The review of medical data for 30,198 women who gave birth at a teaching hospital in Adelaide between 2002 and 2008 showed the risk for postpartum hemorrhaging increased by 5 percent, from 11 to 16 percent, if women were treated with SSRIs. The risk of a severe hemorrhage or postpartum anemia also doubled, the researchers reported.

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The researchers said that while the study linked SSRI use to the increased risk, there is a large number of variables -- from drugs used during delivery to the limited amount of information researchers had about specific medical conditions of the women -- which all could have an effect on the potential for bleeding.

"It is possible that the women who took antidepressants late in pregnancy were those with the most severe illness and it is this which is responsible for the increased risk of postpartum haemorrhage and not the antidepressant," said Dr. Luke Grzeskowiak, a professor at the University of Adelaide. "Based on this study alone we do not recommend that women stop taking medication for depression during pregnancy, but are closely monitored in order to reduce the risk of any potential increased risk of bleeding as much as possible."

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