Doctors recommend avoiding the use of serotonin reuptake inhibitors (SSRIs), some medicines which are used in the treatment of diseases such as depression or obsessive-compulsive disorder, among others, during at least the first trimester of pregnancy. However, a study conducted by Dr. Henning Tiemeier, of the Sofía Children's Hospital in Rotterdam, in the Netherlands, has been published in Archives of General Psychiatry, has revealed that if depression is not treated during pregnancy there is a risk that the fetus suffer a delay in its development. On the other hand, the study also offers data that discourages the administration of these drugs, because it relates their intake with an increased risk of premature birth, and with greater chances of the baby being born with a small head.

There are no conclusive studies on the effects that the administration of antidepressants during pregnancy can have on the long term on the health of the baby

Dr. Tiemeier's research involved more than seven thousand women, of whom 570 showed signs of depression but did not take medication, and only 99 who suffered from the disease and were under treatment with drugs. The researchers carried out various tests to check the severity of the depressive symptomatology, as well as ultrasound scans that allowed them to find out the gestational age of the fetus, its development and weight, and its cephalic contour. They observed that pregnant women with depression who did not take antidepressants gave birth to smaller babies (head and body), whereas babies who continued treatment with drugs during pregnancy did not notice any reduction of the body, but of the head.

The use of antidepressants during pregnancy is a very controversial issue because there are no conclusive studies on the effects that this medication can have on the health of the baby in the long term. But the new study confirms that the disease of the mother affects the development of the fetus, and although the objective cause has not been established, the smaller size that the fetus reaches can be due to several factors, since women with depression who do not follow a treatment during pregnancy are likely to suffer a higher level of stress as a result of their disease, or not eat properly, or consume more tobacco or alcohol, and all this can cause a delay in the growth of the fetus.

In both cases, with medical treatment and without it, women with depression had babies with a lower head circumference, an important perinatal indicator of brain weight, so that a smaller head in a newborn is a factor that is associated with behavioral disorders or psychiatric problems in the future such as hyperactivity, anxiety or cognitive deficit. The specialists consider that the new study continues without clearing the doubts about if it is better or worse for the fetus that the mother follows a pharmacological treatment during the gestation, and they advocate to analyze each case individually, and to value the risks and benefits that implies use of antidepressant medications taking into account their possible adverse effects. They also insist on the convenience of the preconceptional consultation to promote the health of the future pregnant woman and avoid the risks associated with the diseases that may suffer, as well as those inherent in the treatment they require.

#TomorrowsDiscoveries: Depression and Anxiety During Pregnancy – Lauren Osborne, M.D (November 2019).