Pregnant women taking antidepressant medications, especially during the second trimester, have an increased risk of preeclampsia, a potentially serious or even fatal condition for both mother and child, according to a study by Kaiser Permanente Northern California researchers.
The study was published in CNS Spectrums.
Kaiser Permanente Northern California (KPNC) implemented a universal depression screening program for pregnant women in 2009, and then conducted a study that involved 21,589 women. They looked at five groups: women with a diagnosis of depression who were taking antidepressants, or who were alternatively taking psychotherapy or not engaging in any treatment, along with women who were taking antidepressants but not for depression, and women who were neither depressed nor being treated.
Overall, the risk of preeclampsia was 4.5%. “After adjusting for all covariates, compared to women without depression, women who took antidepressant medications and had depression had nearly a 40% increase in the risk of preeclampsia,” wrote the authors. “Among antidepressant users with depression, antidepressant medication exposure in the second trimester was significantly associated with a 70% increase in the risk of preeclampsia compared to women without depression.”
“In contrast,” they wrote, “depressed women with psychotherapy showed no increased risk of preeclampsia compared to women with untreated depression or no depression.”
Though the depressed women taking antidepressants had higher risk than depressed women taking psychotherapy, the authors stated that they recognized this may not have succeeded in distinguishing the risks of depression from the risks of antidepressants, because it was possible people with more severe depression were turning to antidepressants.
“Our findings suggest that antidepressant medication use during the second trimester (13 to 20 weeks) may increase the risk of preeclampsia,” they concluded.
Avalos, Lyndsay Ammon, Hong Chen, and De-Kun Li. “Antidepressant Medication Use, Depression, and the Risk of Preeclampsia.” CNS Spectrums 20, no. 01 (February 2015): 39–47. doi:10.1017/S1092852915000024. (Abstract and full text)