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Antidepressant use during pregnancy: the benefit-risk ratio

Published:February 23, 2012DOI:https://doi.org/10.1016/j.ajog.2012.02.009
      Antidepressants are used commonly in pregnancy. Physicians who provide health care for pregnant women with depression must balance maternal well-being with potential fetal risks of these medications. Over the last decade, scores of original and review articles have discussed whether selective serotonin reuptake inhibitors–selective serotonin norepinephrine reuptake inhibitors possess risks to the fetus; however, very little has been done to integrate these potential risks, if they exist, into an overall context of a benefit:risk ratio. This review aims at presenting an updated analysis of fetal and maternal exposure to selective serotonin or norepinephrine reuptake inhibitors to allow an evidence-based benefit:risk ratio. When a psychiatric condition necessitates pharmacotherapy, the benefits of such therapy far outweigh the potential minimal risks of cardiac malformations, primary pulmonary hypertension of the newborn infant, or poor neonatal adaptation syndrome.

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      Linked Article

      • Patient-centered care for antenatal depression
        American Journal of Obstetrics & GynecologyVol. 207Issue 5
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          Treatment decision-making for depression can be challenging given the wide array of pharmacologic and nonpharmacologic treatments available. Decisions are considerably more complex when depression occurs during pregnancy, because along with maternal well-being, fetal exposures to medication and untreated depression must be considered. More often than not, women do not engage in any treatment for antenatal depression.1 Some pregnant women may not seek treatment if symptoms are not recognized as depression.
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