Use of antidepressants by pregnant women doesn't significantly increase the risk of birth defects, with rare exceptions, two studies found.
The overall risk of having a child with a defect increased by less than 1 percent in women on the drugs, including Pfizer Inc.'s Zoloft, GlaxoSmithKline PLC's Paxil and Forest Laboratories Inc.'s Celexa, according to research published today in The New England Journal of Medicine.
As many as one in five pregnant women has symptoms of depression, according to the American Pregnancy Association, a Texas-based nonprofit organization. Depression can lead to premature birth or low-birth-weight babies, and researchers say women need to balance risks and benefits with their doctors in deciding whether to seek treatment with antidepressants.
"If everyone decides that treatment for depression is appropriate and needed during pregnancy, the overall message from this is relatively reassuring," Michael Greene, director of obstetrics at Massachusetts General Hospital in Boston, said yesterday. He wrote an accompanying editorial in the journal.
Individually, Paxil was tied in one of the studies to a defect that affects blood flow to the lungs, while Zoloft was linked to two rare disorders involving defects in the baby's intestines and heart chambers.
Margaret Spinelli, an assistant professor at Columbia University College of Physicians and Surgeons in New York, said that while the new research may make doctors more cautious in prescribing antidepressants, pregnant women with serious depression will still need treatment.
"If the risk of being on a medicine is relatively safer than the illness itself, you are more likely to choose the medication," she said yesterday.
Public health expert Carol Louik, lead author of one study, said: "It's important to keep in perspective that the absolute risks are relatively small. It's a very difficult thing to prove safety. The best we can really do is place an upper bound on what the risk might be."