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Close monitoring needed for those taking SSRIs while pregnant

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Mothers on commonly prescribed antidepressants should be closely monitored after giving birth, according to a study that suggests taking such drugs could increase the risk of haemorrhage.

This is one of the key findings from a series of studies, which shed new light on the impact of selective serotonin reuptake inhibitors (SSRIs) on the health of mother and child.

“These results should not discourage healthcare professionals from prescribing or continuing anti-depressant treatment to those who need it”

Marte Handal

The three new papers by Norwegian and Australian researchers have been published in BJOG: An International Journal of Obstetrics.

One study by Australian researchers looked at risk of postpartum haemorrhage – severe blood loss after birth – among mothers who took SSRIs in the final three months of pregnancy at the Women’s and Children’s Hospital in Adelaide.

For women who did not have a psychiatric illness or were not taking anti-depressants the risk of postpartum haemorrhage was 11%.

However, the risk increased to 16% for those taking anti-depressants.

Lead author Dr Luke Grzeskowiak, from the University of Adelaide, urged caution when interpreting the results as other unknown factors could be at play.

“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,” he said.

In a separate study, the same team analysed data on 49,000 Danish women to look at the possible impact of using SSRIs during pregnancy on children’s behaviour.

They found children born to mums whose depression was not treated were more likely to have behaviour problems by age seven.

“We do not recommend that women stop taking medication for depression during pregnancy but are closely monitored”

Luke Grzeskowiak

However, this increased risk was not seen in children whose mothers had taken anti-depressants, including SRRIs.

A further study, from the Norwegian Institute of Public Health, assessed the effect of SSRI use on the development of young children’s motor skills.

Researchers looked at data from more than 51,000 children born in Norway and found that those born to mums who reported prolonged use of SSRIs while pregnant – just 159 mothers in total – were slightly behind children who had not been exposed to the drugs.

Of those a very small number had a severe delay. However, the team stressed the numbers were so small that the findings should not alter clinical practice.

“Effective treatment of depression during pregnancy is essential and these results should not discourage healthcare professionals from prescribing or continuing anti-depressant treatment to those who need it,” said lead author Marte Handal.

 

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