Depression Tx risks, benefits unclear for pregnant patients

Indirect evidence suggested future studies should focus on congenital anomalies, autism spectrum, and attention deficit disorders in offspring.

Not enough evidence on depression meds in pregnancy, postpartum period
Not enough evidence on depression meds in pregnancy, postpartum period

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

To examine the harms and benefits of antidepressant treatment in pregnant and postpartum female patients, Marian S. McDonagh, PharmD, of the Oregon Health and Science University in Portland, and colleagues reviewed data from six randomized controlled trials and 15 observational studies.

The risk of respiratory distress was higher for neonates of pregnant patients with depression taking selective serotonin reuptake inhibitors versus neonates of untreated female patients (13.9% versus 7.8%; P<0.001), but no difference was seen in neonatal convulsion risk (0.14% versus 0.11%; P=0.64) or preterm birth (17% versus 10%; P=0.7).

In studies of pregnant female patients assigned antidepressants for mixed or unreported reasons versus pregnant patients not taking antidepressants (depression status unknown), indirect evidence suggested future studies should focus on congenital anomalies and autism spectrum 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," wrote the researchers. "Considering the prevalence of depression, filling this gap is essential."

References

  1. McDonagh M et al. Obstetrics & Gynecology. 2014; doi: 10.1097/AOG.0000000000000410
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