Pregnancy, does not protect women from affective or anxiety disorders, and psychotropic medications are frequently used during pregnancy. However, risk of prenatal complications associated with antidepressant use remains unclear. Dr. Cohen and colleagues examined prenatal outcomes in pregnant women taking a variety of antidepressants, including fluoxetine, paroxetine, sertraline, nortriptyline, imipramine, desipramine, amitriptyline, clomipramine, and bupropion.

Sixty-five children were born to women receiving antidepressant pharmacotherapy for mood and/or anxiety disorders, compared with 100 infants born to healthy, drug-free mothers. Compared with infants not exposed to antidepressants during pregnancy, the 65 infants whose mothers took antidepressants during pregnancy showed no significant differences in birth weight, gestational age, or Apgar scores. Readily apparent treatment-emergent adverse events were not observed in infants whose mothers took antidepressant medications during pregnancy, labor, and delivery.

Dr. Cohen concluded that use of antidepressant medications during labor and delivery is not associated with clinically significant treatment-emergent adverse effects. Long-term neurobehavioral effects of fetal antidepressant exposure remain unknown, however. Clinicians are advised to continue antidepressant medication during labor and delivery because of the high risk for relapse postpartum. The postpartum period is associated with increased likelihood of depressive recurrence and with worsening of affective or anxiety disorders.