A narrative review of the risks of antidepressants and depression in pregnancy
DOI:
https://doi.org/10.25118/2763-9037.2012.v2.886Keywords:
depression, antidepressants, pregnancyAbstract
Introduction: Depression is an increasingly common illness during pregnancy and is associated with adverse outcomes for the mother and newborn (NB). There is an increase in the use of antidepressants in women of reproductive age. Antidepressants are the most frequently studied medications for the treatment of mental disorders. Objective: This article reviews the repercussions of depression during pregnancy, in addition to the safety of antidepressant use during pregnancy. Method: This is a narrative review of the content of a collection of articles extracted from Medline between 2005 and 2012. The descriptors used were: “antidepressants” and “pregnancy”. Relevant articles cited in reviews prior to 2005 were also consulted. Results: Although widely studied, it is still unclear whether there is an increased risk of malformations, persistent pulmonary hypertension in newborns, prematurity, low birth weight, and negative outcomes in child development. There are neonatal symptoms of poor adaptation associated with the use of antidepressants during pregnancy. Conclusion: Randomized controlled trials of antidepressants during pregnancy have not been conducted for ethical reasons, but observational data suggest that they are relatively safe. Women with depression should be informed of the risks associated with medication, as well as those associated with untreated depression.
Downloads
Metrics
References
Gavin NI, Gaynes BN, Lohr KN, Meltzer-Brody S, Gartlehner G, Swinson T. Perinatal depression: a systematic review of prevalence and incidence. Obstet Gynecol. 2005;106:1071-83. DOI: https://doi.org/10.1097/01.AOG.0000183597.31630.db
Silva RA, Jansen K, Souza LDM, Moraes IGS, Tomasi E, Silva GDG, et al. Depression during pregnancy in the Brazilian public health care system. Rev Bras Psiquiatr. 2010;32:139-44. DOI: https://doi.org/10.1590/S1516-44462010000200008
Pereira PK, Lovisi GM, Pilowsky DL, Lima LA, Legay LF. Depression during pregnancy: prevalence and risk factors among women attending a public health clinic in Rio de Janeiro, Brazil. Cad. Saúde Pública. 2009;25:2725-36. DOI: https://doi.org/10.1590/S0102-311X2009001200019
Faisal-Cury A, Menezes P, Araya R, Zugaib M. Common mental disorders during pregnancy: prevalence and associated factors among low-income women in São Paulo, Brazil. Arch Womens Ment Health. 2009;12:335-43. DOI: https://doi.org/10.1007/s00737-009-0081-6
Lovisi GM, Lopez JR, Coutinho ES, Patel V. Poverty, violence and depression during pregnancy: a survey of mothers attending a public hospital in Brazil. Psychol Med. 2005;35:1485-92. DOI: https://doi.org/10.1017/S0033291705005362
Manzolli P, Nunes MAA, Schmidt MI, Pinheiro AP, Soares RM, Giacomello A, et al. Violence and depressive symptoms during pregnancy: a primary care study in Brazil. Social Psychiatry and Psychiatric Epidemiology. 2010;45:983-8. DOI: https://doi.org/10.1007/s00127-009-0145-y
Melville JL, Gavin A, Guo Y, Fan M, Katon WJ. Depressive Disorders During Pregnancy:Prevalence and Risk Factors in a Large Urban Sample. Obstet Gynecol. 2010;116:1064-70. DOI: https://doi.org/10.1097/AOG.0b013e3181f60b0a
Davalos DB, Yadon CA, Tregellas HC. Untreated prenatal maternal depression and the potential risk to offspring: a review. Arch Womens Ment Health. 2012;15:1-14. DOI: https://doi.org/10.1007/s00737-011-0251-1
Allister l, Lester BM, Carr S, Liu J. The effects of maternal depression on fetal heart rate response to vibroacoustic stimulation. Dev Neuropsychol. 2001;20:639-51. DOI: https://doi.org/10.1207/875656401753549843
Dieter JNI, Field T, Hernandez-Reif M, Jones NA, LeCanuet JP, Salman FA, et al. Maternal depression and increased fetal activity. J Obstet Gynaecol. 2001;21:468-73. DOI: https://doi.org/10.1080/01443610120072009
Diego MA, Filed T, Hernandez-Reif M, Kuhn C, Gonzalez-Quintero VH. Prenatal depression restricts fetal growth.
Early Hum Dev. 2009;85:65-70. DOI: https://doi.org/10.1016/j.earlhumdev.2008.07.002
Field T, Diego MA, Hernandez-Reif M, Schanberg S, Kuhn C, Yando R, et al. Prenatal depression effects on the fetus and the newborn. Infant Behav. 2004;27:216-29. DOI: https://doi.org/10.1016/j.infbeh.2003.09.010
Field T, Diego MA, Hernandez-Reif M, Figueiredo B, Schanberg S, Kuhn C. Chronic prenatal depression and neonatal outcomes. Int J Neurosci. 2008;118:95-103. DOI: https://doi.org/10.1080/00207450601042144
Steer RA, School TO, Hediger ML, Fischer RL. Self-reported depression and negative pregnancy outcomes. J Clin Epid. 1992;45:1093-9. DOI: https://doi.org/10.1016/0895-4356(92)90149-H
Dayan J, Creveuil C, Marks MN, Conroy S, Herlicoviez M, Dreyfus M, et al. Prenatal depression, prenatal anxiety, and spontaneous preterm birth: a prospective cohort study among women with early and regular care. Psychosomatic Medicine. 2006;68:938-46.
Oberlander T, Warburton W, Misri S, Aghajanian J, Hertzman C. Neonatal outcomes after prenatal exposure to selective serotonin reuptake inibitor antidepressants and maternal depression using population-based linked health data. Arch Gen Psychiat. 2006;63:898-906. DOI: https://doi.org/10.1001/archpsyc.63.8.898
Dayan J, Creveuil C, Marks MN, Conroy S, Herlicoviez M, Dreyfus M, et al. Prenatal depression, prenatal anxiety, and espontaneous preterm birth: a prospective cohort study among women with early and regular care. Psychosom Med. 2006;68:938-46. DOI: https://doi.org/10.1097/01.psy.0000244025.20549.bd
Field T, Fox N, Pickens J, Nawrocki T. Relative right frontal EEG activetion in 3-to 6-month-old infants of “depressed” mothers. Developmental Psychology. 1995;31:358-63. DOI: https://doi.org/10.1037//0012-1649.31.3.358
Field T, Pickens J, Fox N, Nawrocki T, Gonzalez J. Vagal tone in infants of depressed mothers. Development and Psychopathology. 1995;7:227-31. DOI: https://doi.org/10.1017/S0954579400006465
Abrams SM, Field T, Scafidi F, Prodomidis M. Newborns of depressed mothers. Infant Mental Health Journal. 1995;16:233-9. DOI: https://doi.org/10.1002/1097-0355(199523)16:3<233::AID-IMHJ2280160309>3.0.CO;2-1
Ertel KA, Koenen KC, Rich-Edwards JW, Gillman MW. Antenatal and postpartum depressive symptoms are differentially associated with early childhood weight and adiposity. Paed Perinatal Epidemiol. 2010;24:179-89. DOI: https://doi.org/10.1111/j.1365-3016.2010.01098.x
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2012 Amaury Cantilino , Carla Fonseca Zambaldi
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Debates em Psiquiatria allows the author (s) to keep their copyrights unrestricted. Allows the author (s) to retain their publication rights without restriction. Authors should ensure that the article is an original work without fabrication, fraud or plagiarism; does not infringe any copyright or right of ownership of any third party. Authors should also ensure that each one complies with the authorship requirements as recommended by the ICMJE and understand that if the article or part of it is flawed or fraudulent, each author shares responsibility.
Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) - Debates em Psiquiatria is governed by the licencse CC-By-NC
You are free to:
- Share — copy and redistribute the material in any medium or format
- Adapt — remix, transform, and build upon the material
The licensor cannot revoke these freedoms as long as you follow the license terms. Under the following terms:
- Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- NonCommercial — You may not use the material for commercial purposes.
No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
