A Common Clinical Conundrum: Antidepressant Treatment of Depression in Pregnant Women

Overview

Journal Semin Perinatol

Specialty Gynecology & Obstetrics

Date 2020 Feb 23

PMID 32085857

Citations 9

Authors

Gabrielle A Mesches

Katherine L Wisner

Hannah K Betcher

Affiliations

Soon will be listed here.

Abstract

Depression during pregnancy is associated with adverse maternal, pregnancy, and infant outcomes. Treatment during pregnancy requires a balanced discussion of the risks of both drug exposure and untreated depression. An updated review of the epidemiology, outcomes, and management of maternal depression is presented. Adverse outcomes are associated with both maternal depression and antidepressants. Research gaps include data on the longitudinal developmental trajectory of offspring exposed to antidepressants compared to depression, with assessment of in utero symptom exposure and environmental exposures. Additionally, neonatal syndrome associated with antidepressant use during pregnancy has no consensus definition or mechanistic explanation. With sophisticated large-scale epidemiologic studies, there has been progress in distinguishing the impact of depression processes from medication used for treatment. Optimal treatment of perinatal depression includes close symptom monitoring and medication adjustments to maintain symptom remission. This evolving field requires frequent consultation with reproductive data sources included in this article.

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