Antidepressants and Preterm Birth: More Concerning Findings
An important new research paper was published this week on the topic of antidepressant use during pregnancy and preterm birth. The issue is a crucial one as preterm birth (i.e. birth at less than 37 weeks gestational age) is one of the most challenging problems facing the obstetrical community today. Rates of preterm birth have been increasing over the past two decades. Babies born early have increased risks of morbidity and mortality. At the same time, rates of antidepressant use during pregnancy have increased dramatically. In the 1970s and 1980s rates of antidepressant use in pregnancy were less than 1%. These rates have rapidly increased over the past 25 years and now around 10% of pregnant American women are on these medications. So the following questions are crucial: what are the effects of antidepressant medications on pregnancy and the developing fetus? Are these medications linked to the important problem of preterm birth?
In this new research study Krista Huybrechts, MS, PhD, and her co-authors (of which I was one) did a comprehensive search of studies on women taking antidepressants during pregnancy. Of the many studies on the topic, we found 41 that had information comparing women on antidepressants to those not taking the medications, as well as information about when the patients delivered (i.e. whether they were preterm births or not.) We then did a detailed meta-analysis and found that an overwhelming majority of the studies (39 of the 41) showed increased rates of preterm birth in the antidepressant group. When all studies were combined there was roughly a doubling of preterm birth risk in women on these medications into the third trimester.