Untreated, antenatal (pre-pregnancy) depression is associated with unhealthy lifestyle choices, adverse pregnancy outcomes like preterm birth <32 weeks gestation, and even future “behavioral and psychiatric illness in the offspring,” reports the American Journal of Obstetrics.

Contrast this with reports that suggest treatment of depression with SSRIs (Selective Serotonin Reuptake Inhibitors) may cause birth defects and increase miscarriage rates. So what’s a girl to do? Leave the depression untreated, or risk issues linked to medication?

Dr. Bill Meyer of Carolina Conceptions summarizes the article for patients: “The main problem with these studies (prenatal risks linked to SSRI’s) is that they did not factor out the effect of depression independently on birth defects. Studies that have failed to adequately control for perinatal depression with regards to SSRI exposure, often falsely show a risk associated with SSRIs’, rather than the disease they are prescribed to treat.”

Although the risk of miscarriage with antenatal SSRI exposure is conflicting, Dr. Meyer notes, “It appears untreated depression increases the risks to pregnancy even more. Multiple large studies have not found or been associated with major congenital malformations and in utero exposure to SSRI’s. The bottom line is, SSRI’s can be used safely while attempting to conceive, and during pregnancy.”


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