May 25, 2012 — A new study has found that the maternal use of SSRI antidepressants (including Celexa, Zoloft, Prozac, Lexapro, and more) could increase the risk of premature birth. The researchers concluded that the drugs themselves were responsible for the increased risk, and not the underlying depression. The study was published today in the journal Epidemiology.
In recent years, a growing number of studies have associated SSRI antidepressants with premature birth, but there was no consensus on whether the risk was due to the drugs or the underlying depression.
The fact that the researchers found no link between depression itself and prematurity should be good news for depressed pregnant women, who may have been concerned that their depression could adversely impact their pregnancy.
Kim Yonkers, professor of gynecology, obstetrics, and psychiatry, said, “This study tells them they should not worry that they are somehow compromising their pregnancy because they are depressed. And when considering whether to take medication for depression, women should understand that the risk of preterm birth is only one of many factors they should weigh.”
Nearly 3,000 depressed pregnant women participated in the study. Some of the women treated depression with medications, while others did not. Controlled variables included age, health history, use of drugs, and socioeconomic status.
The researchers found that the use of antidepressants during pregnancy increased the risk of late preterm birth, which is defined as a pregnancy that lasts between 34-37 weeks. A full-term birth lasts between 37-40 weeks. The good news is, late preterm babies do not have the same health risks as early premature births.
The results of this study add to the growing evidence linking prematurity to antidepressant drugs. Several studies of pregnant sheep who were given antidepressants found that the drugs could cause transient reductions in the amount of blood flowing to the uterus. If the drugs were taken during the entire pregnancy, it is possible that the baby could suffer poor growth due to lack of oxygen and nutrient. This presents a mechanism by which antidepressants could increase the risk of premature birth.
The authors of the study cautioned that the decision on whether or not to medicate depression during pregnancy is often a difficult, emotional decision. Although several studies have found small increased risks of birth defects and pregnancy complications, the risk of untreated depression can also pose risks to the baby. If the mother does not take care of herself, does not get adequate nutrition, or self-medicates using alcohol or illicit drugs — these can all severely harm a baby. Furthermore, there is evidence that suddenly starting or stopping an antidepressant can also harm a fetus.
Therefore, pregnant women should talk to their doctor before making any decisions about whether to start, stop, or take an antidepressant during pregnancy.
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