Are antidepressants safe for mums-to-be?

Apparently, there is a link between use of antidepressants during the first trimester of pregnancy and birth defects. According to this report, Montreal researchers claim that it’s a matter of concern considering that intake of antidepressants by an increasing number of mums-to-be is leading to almost double the chances of some congenital malformation in the babies.

According to Dr Gauree Pimpralekar, MD, DGO, Consultant - Obstetrician, Gynaecologist and Infertility Specialist, Sahyadri Hospital, Nashik, “Many antidepressants are not safe during pregnancy. They are known to cause certain birth defects. Pulmonary hypertension in the new born, heart defects, preterm delivery to birth defects like Anencephaly- affecting spinal cord and brain, Craniosynostosis - affecting skull development, Omphalocele- limb malformation, limb defects, are some of the complications that might show up.”

But then, the opinions are varied. Dr Nilesha Chitre, Gynecologist, SRV Hospital feels most of the antidepressants are safe during pregnancy and the overall risk of having birth defects is 3-5%. “With an intake of antidepressants during pregnancy, there is no significant rise in birth defects,” she says. However, she also adds that mild depression or symptom-free period of more than six months don't require medicines during pregnancy.

Depression is a sensitive topic. Add pregnancy to it, and it becomes like a double-edged sword. What do you focus on? While pregnancy is definitely not a disease, it’s a phase in which the mum-to-be needs to be extra careful. However, dealing with depression at such times becomes difficult and resorting to professional help is always advisable.

Artemis Hospital’s senior consultant, obstetrics and gynaecology, Dr Renu Raina Sehgal feels a decision to use antidepressants during pregnancy is based on the balance between risks and benefits. Overall, the risk of birth defects and other problems for babies of mothers who take antidepressants during pregnancy is very low. Still, few medications have been proved safe without question during pregnancy, and some types of antidepressants have been associated with health problems in babies.

“Treating depression is important in pregnancy, if not treated, the mother might not be able to give optimal care for the baby. She might start drinking alcohol and smoking. This could result in premature birth. Other problems may include baby being born with low birth weight. The mother might also have difficulty in bonding with the baby after it is born,” informs Dr Anu Sridhar, Consultant Obstetrics & Gynaecologist Fortis Hospital, Bannerghatta Road, Bangalore.

While prenatal depression is quite common, varying in intensity, of course, it's vital to consult a professional before taking any steps. To begin with, thanks to the hormonal changes, women are bound to feel low during pregnancy. That in itself doesn't qualify as depression. Most often, it's only if the mum-to-be experiences symptoms like low energy, change in appetite, anxiety, lack of sleep, frequent crying, etc., for over two weeks, does she need to raise the red flag.

However, if you feel you aren’t clinically depressed and it’s just the hormones playing truants, indulge in a healthy routine. Be it going for a walk, indulging in some group exercise, talking to friends or close family, or just taking up a hobby, having a set pattern helps. As Dr Chitra states, one must keep in mind that while pregnancy can aggravate depressed condition due to hormonal changes, mild variety can be tackled by counselling, lifestyle changes like taking up outdoor activity, yoga and other exercises.

However, moderate to severe conditions require medicine support after joint consultation of psychiatrist and obstetrician. "Untreated depression can be detrimental. Such patients are unable to take care of themselves, may take up alcohol, drugs or smoking which inturn is quite harmful to pregnancy leading to increased risk of miscarriage, preterm births, birth defects, low birth weight problems," she informs.

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