Antidepressant Medication Use in Pregnancy

Barbara Hackley, CNM, MSN

Disclosures

J Midwifery Womens Health. 2010;55(2):90-100. 

In This Article

Abstract and Introduction

Abstract

Depression has been estimated to occur in approximately 12% of women, making it one of the most commonly encountered medical conditions affecting pregnancy. Yet many health care providers feel unprepared to manage this condition in pregnancy. This article provides women's health providers the background needed to effectively manage depression and in particular focuses on the use of antidepressant medication in pregnancy.

Introduction

Depression is one of the most commonly encountered conditions in primary care and is particularly common among women. Lifetime prevalence rates have been reported to be 6.3% in men and 12.6% in women (P < .01).[1] Given the high prevalence rates in the general population, it is not surprising that depression may be the most common medical condition affecting pregnant women. Depression has been reported to occur in 12% to 15% of women in the perinatal period;[2,3] these prevalence rates are even higher than those reported for gestational diabetes (4%–8%)[4] or preeclampsia (3%).[5] Yet depression is a condition for which many women's health care providers feel unprepared to detect or manage.[6] Recent reports of neonatal complications associated with the use of some commonly used antidepressants makes the management of depression even more complex.[7–9] An earlier article in this journal covered the specifics of screening, diagnosis, counseling, and medication management in the general population.[10] This article will focus on the safety of antidepressants and the medication management of depression during pregnancy ( Table 1 ).

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