In the U.S., 5% to 6% of pregnant women receive treatment with SSRIs, most often for major depressive disorder.Evidence suggests that serious adverse outcomes are unlikely with the use of SSRIs in pregnancy, once the effects of the drug are separated from confounders such as the impact of underlying psychiatric illness.Researchers emphasized the importance of structured decision-making processes, including the use of visual aids to help patients understand the research.
For pregnant women with major depressive disorder (MDD), serious adverse outcomes are unlikely with the use of selective serotonin reuptake inhibitors (SSRIs), researchers said.
After thalidomide used for morning sickness led to congenital malformations in more than 10,000 children decades ago, "fear of another drug-associated devastating fetal effect has overshadowed concern about the impact of maternal disorders on maternal-fetal health," wrote Katherine L. Wisner, MD, of the Developing Brain Institute at Children's National Hospital in Washington, D.C., and co-authors in a special communication in JAMA Psychiatry.
However, there's been a change in recent years. "Once the impact of the drug is disentangled from that of MDD and its sequelae, accumulated evidence suggests that SSRIs carry little or no risk for serious adverse outcomes," the authors noted. "The thrust of the field has shifted to prioritize treatment of MDD to optimize maternal health."
