The use of selective serotonin reuptake inhibitor (SSRI) antidepressants during pregnancy may influence an infant’s head size, according to a recent study. This finding is only the latest in a series of problems associated with taking SSRIs during pregnancy. Over the past few years, it has been found that taking this class of antidepressants may cause a host of birth complications.
SSRIs such as Prozac (fluoxetine), Paxil (Paroxetine), Zoloft (sertraline hydrochloride), Lexapro (escitalopram), Celexa (citalopram) and Effexor (venlafaxine), are antidepressants that work by preventing serotonin reabsorption, thus increasing its concentration in the body. Researchers believe that one’s mood is strongly affected by serotonin levels.
The latest study is certainly not the first time SSRIs have been linked to birth defects. In 2005, the FDA warned about potential birth complications associated with taking Paxil during the first trimester. Studies showed that the drug may increase the newborn’s risk of cardiac complications, including atrial septal defects (ASD) and ventricular septal defects (VSD). The following year, the agency issued an additional Public Health Advisory concerning the risk between prenatal SSRI exposure and a serious respiratory disorder known as persistent pulmonary hypertension of the newborn (PPHN). This past January, a study analyzing 1.6 million pregnant women across five different countries further supported this relationship.
In 2011, a study published in the journal Archives of General Psychiatry indicated that prenatal SSRI exposure may also be linked autism and autism spectrum disorders.
The most recent study adds more evidence regarding the increased risk of birth complications and SSRI use during pregnancy. The study, published in the Archives of General Psychiatry, was led by Hanan El Marroun and his colleagues. El Marroun is a postdoctorate fellow specializing in child and adolescent psychiatry at Sophia Children’s Hospital and Erasmus Medical Center in Rotterdam, the Netherlands. Out of the 7,700 pregnant women studied by El Marroun’s team, 91 percent exhibited little to no symptoms of depression, 7 percent had symptoms but were not treated with SSRIs and 1 percent had depression and took SSRIs. They found that the mothers who did not use SSRIs to treat their symptoms tended to give birth to smaller children overall; they exhibited a smaller head circumference and had smaller bodies. In comparison, the mothers who took SSRIs tended to have children with a smaller head circumference but a generally unaffected body size. This discrepancy indicates that the head growth differences are a res
ult of the SSRI, rather than the depression itself.
According to El Marroun, “Fetal body growth is a marker of fetal health and fetal head growth is a marker for brain development.” cites HealthDay. Studies suggest that a small head size in infants up to 4 weeks old may be associated with psychiatric and behavioral problems later in life, although researchers are cautious about stating a causal relationship between prenatal SSRI exposure and a child’s future development. El Marroun’s research only adds to the growing literature about the harmful effects of antidepressants on unborn children; if studies continue to identify similar findings, it may influence pregnant mothers to seek alternatives, such as psychotherapy or behavioral therapy. Professor of psychology at the University of Iowa told HealthDay, “These psychological treatments allow a woman to avoid antidepressant medication, but at the same time receive very good treatment for their depression,”