Literature accumulated over the last decade supports the use of certain selective serotonin reuptake inhibitors (SSRIs) and the older tricyclic antidepressants during pregnancy, indicating no overall increase in the risk of congenital malformation in children exposed to these medications during the first trimester of pregnancy. Still, questions remain regarding the reproductive safety of SSRIs, including one report suggesting an association between exposure to SSRIs late in pregnancy and persistent pulmonary hypertension of the newborn (PPHN) and several other reports suggesting that paroxetine use may be be associated with an increased risk of cardiovascular malformation.

A study presented at the annual meeting of American Psychiatric Association did not report any association between SSRI use and these potentially serious complications. Researchers at the Mayo Clinic in Rochester, Minnesota reviewed the medical records of 25,214 deliveries, including 745 mothers who had been treated with SSRIs during their pregnancies. They found no association between the SSRI use during pregnancy and the occurrence of PPHN. Of the 16 infants diagnosed with persistent pulmonary hypertension, none had been exposed to SSRIs. Furthermore, the study did not demonstrate any association between SSRI use and any cardiovascular malformations, including septal defects.

This study, like many earlier studies, suggest that the risks associated with SSRI use during pregnancy are low. While women considering the use of antideprssants during paregnancy must be counseted regarding the use of these agents during pregnancy, they must also be informed of the effects of untreated depression during pregnancy.