New research from Brigham and Women’s Hospital (BWH) in Boston says actually, it may be OK for women to take antidepressants during late stages of their pregnancy.

In 2006, the Food and Drug Administration issued a public health advisory for expectant mothers, saying the use of antidepressants in late pregnancy may increase risk for persistent pulmonary hypertension (PPHN). This condition increases a newborn’s blood pressure, possibly causing shortness of breath and difficulty breathing; in more severe scenarios, it could cause heart failure. Separate research has suggested pregnant women taking antidepressants may also increase risk for diabetes and obesity in offspring.

The FDA’s advisory, however, was based on a single study that found women taking selective serotonin reuptake inhibitors (SSRI) — the most commonly prescribed antidepressant — were at a six-fold increase for having newborns with PPHN, researchers reported. Upon learning this, and considering other studies, the FDA revised their recommendation to say they didn’t have enough evidence to say for sure taking antidepressants would raise risk for PPHN.

So BWH teamed up with the Harvard T.H. Chan School of Public Health to examine the risk of PPHN associated with both SSRI and non-SSRI antidepressants, as well as PPHN associated with women not taking antidepressants at all. Their study included over three million women in the U.S. enrolled in Medicaid: 2.7 were taking an SSRI and 0.7 percent were taking a non-SSRI. The results showed nearly 32 per 10,000 infants exposed to SSRIs and nearly 20 per 10,000 infants exposed to non-SSRIs developed PPHN. Of the women not taking any form of antidepressants, about 20 per 10,000 infants developed the condition.

The increase among women taking antidepressants represents an almost 50 percent increased risk for newborn PPHN. Yet, when researchers accounted for differences among women taking and not taking antidepressants, this significant increase was no longer. While researchers acknowledge it’s possible an increased risk for PPHN could be associated with maternal use of antidepressants, “the absolute risk is small and the risk increase, if present, appears more modest than suggested in previous studies.”

Dr. Krista Huybrechts, corresponding author of the study and epidemiologist in the Division of Pharmacoepidemiology and Pharmacoeconomics at BWH, concluded in a press release: "Clinicians and patients need to balance the potential small increase in the risk of PPHN, along with other risks that have been attributed to SSRI use during pregnancy, with the benefits attributable to these drugs in improving maternal health and well-being."

Source: Huybrechts KF, et al. Antidepressant Use Late in Pregnancy and Risk of Persistent Pulmonary Hypertension of the Newborn. JAMA. 2015.