Great — another study to make depressed pregnant women feel even worse
This week, another study about pregnant women was published. Another study pregnant women really shouldn't bother reading — particularly depressed ones who have enough to deal with already.
A large cohort study by a team led by researchers at Columbia University Medical Center and Turku University in Finland looked at whether exposure to certain antidepressants during pregnancy increased the child's risk of adverse speech, scholastic or motor outcomes.
The study suggests that children of women who take selective serotonin re-uptake inhibitors, known as SSRIs, during pregnancy are at a higher risk of language disorders, including dyslexia.
As if living with a mental illness during pregnancy isn't difficult enough, this will come as a blow to the estimated 6 to 10 percent of pregnant women worldwide who are on antidepressants. Particularly when it is being reported by some outlets that such children "were much more likely to have these types of speech and language disorders than those [born to mothers] who did not use this medication."
The researchers say that children of women who take SSRIs during pregnancy have a 37 percent greater risk of speech or language disorders than children of depressed but unmedicated mothers.
But this needs to be given some context. If a depressed woman did not take antidepressants, her child's risk of being diagnosed with a speech or language disorder would be around 1 percent. If she took an SSRI to treat her illness, the risk would increase to 1.37 percent.
Granted, it's a higher risk. But it's a very low risk that's higher than another very low risk, and that risk has to be weighed alongside another (potentially much higher) risk — that of leaving a mental illness untreated during pregnancy. That's something for every mom-to-be and her doctor to discuss and weigh, possibly with input from other health professionals.
Making the decision to continue to stop taking antidepressants during pregnancy is extremely difficult. While SSRIs are an effective treatment for many with mental illness (they work by keeping the "contentment" neurotransmitter serotonin in the brain), they can also be absorbed by the placenta. There's a ton of research on the effects of SSRIs on unborn children, and it's far from conclusive. Connections have been made to autism spectrum disorders and fetal heart defects. However, a large body of evidence concludes that taking SSRIs during pregnancy is generally safe, and the risks of birth defects and other problems are very low.
Ultimately, taking antidepressants during pregnancy may be the right thing for some mothers, but not for others. A mother with mild depression who has been symptom-free for several months may be able to treat her illness without medication, for example through psychotherapy. On the other hand, a mother who has a history of severe or recurrent depression or another mental illness, such as bipolar disorder, or who has been at risk of suicide may be putting herself and her unborn child at greater risk if she were to stop taking antidepressants.
Of course we need research into the effects of antidepressants during pregnancy to be carried out. But we also need the results to be relayed to expectant mothers in a way that will educate and inform, not alarm.