Journal
BEST PRACTICE & RESEARCH CLINICAL OBSTETRICS & GYNAECOLOGY
Volume 28, Issue 1, Pages 37-48Publisher
ELSEVIER SCI LTD
DOI: 10.1016/j.bpobgyn.2013.09.001
Keywords
prenatal maternal depression; serotonin reuptake inhibitors; infant outcomes
Categories
Funding
- Canadian Institutes for Health Research
- Michael Smith Foundation for Health Research
- Women's Health Research Institute
- Neurodevnet
- Child and Family Research Institute
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Depression, anxiety, or both, during pregnancy are common complications during the perinatal period, with 15-20% of women experiencing depression at some point during their pregnancy. Considerable evidence suggests that untreated or undertreated maternal Axis I mood disorders can increase the risk for preterm birth, low birth weight, and alter neurobehavioral development in utero. Serotonin reuptake inhibitor antidepressants are often considered for antenatal therapy, with the goal of improving maternal mental health during pregnancy. Treatment with a serotonin-reuptake inhibitor, however, does not guarantee remission of depression, and in-utero serotonin reuptake inhibitor exposure has also been linked to increased risks for adverse infant outcomes. In this chapter, evidence linking serotonin reuptake inhibitor use with an increased risk for postnatal adaptation syndrome, congenital heart defects, and neonatal persistent pulmonary hypertension is reviewed. Management decisions should include attention to the continuum of depression symptoms, from subclinical to severe major depressive disorder and the long-term developmental risks that might also be associated with pre- and postnatal exposure. (C) 2013 Elsevier Ltd. All rights reserved.
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