HealthDay News  — The current evidence is inadequate for assessing the benefits and harms of depression treatment in pregnancy and the postpartum period, according to a review published online in Obstetrics & Gynecology.

Marian S. McDonagh, PharmD, from the Oregon Health and Science University in Portland, and colleagues examined the benefits and harms of antidepressant treatment in pregnant and postpartum women. Data were reviewed from six randomized controlled trials and 15 observational studies.

The risk of respiratory distress was higher for neonates of pregnant women with depression who were taking selective serotonin reuptake inhibitors versus neonates of untreated women (13.9 vs. 7.8%; P<0.001), the researchers found. 

There were no significant differences in neonatal convulsion risk (0.14% vs. 0.11%; P=0.64) or preterm birth (17% vs.10%; P=0.7).

In studies involving pregnant women who received antidepressants for mixed or unreported reasons versus those not taking antidepressants (depression status unknown), indirect evidence suggested future studies should focus on congenital anomalies, autism spectrum disorders, and attention deficit disorders in offspring. Insufficient evidence was available for other outcomes.

“Evidence about the comparative benefits and harms of pharmacologic treatment of depression in pregnant and postpartum women was largely inadequate to allow informed decisions about treatment,” the authors wrote. “Considering the prevalence of depression, filling this gap is essential.”


McDonagh, MS, et al. Obstetrics & Gynecology. doi: 10.1097/AOG.0000000000000410