SSRIs and Birth Defects: Pregnant Women Face Heartbreaking Decisions

Boston, MAIt is probably safe to say that most pregnant women make important—and difficult—decisions every day of their pregnancy. They have to choose what food is safe to eat, what they can and cannot drink and what chemicals they should or should not be around. Every decision is made in the best interests of their unborn child—they do everything they can to ensure their child is born with the best possible chance of being healthy. So, when the choice is made to take an SSRI (selective serotonin reuptake inhibitor) or to struggle through depression, many women naturally listen when their doctor tells them it is safer to take the antidepressant than not, not realizing there might be a chance their child could be born with birth defects.

Now, conflicting studies have come out regarding the safety of those SSRIs, which include Paxil, Zoloft and Celexa. Some studies suggest babies exposed to SSRIs prior to birth have a higher risk of birth defects than babies not exposed to SSRIs. Others have suggested there is no increased risk, leaving expectant mothers unsure of what to do.

Among the studies that suggest a link between exposure to SSRIs and birth defects are articles published in The New England Journal of Medicine that found an increased risk when exposure took place during specific periods during a pregnancy. The birth defects involved included PPHN (persistent pulmonary hypertension of the newborn), omphalocele, craniosynostosis and anencephaly.

However, a study (also) published in The New England Journal of Medicine found that although there was a suggested link between individual SSRIs and certain birth defects, there was no link between overall use of the SSRIs. Furthermore, the study found the specific birth defects that were associated with specific SSRIs were quite rare.

One conclusion that most studies involving SSRIs and birth defects make is that further testing is required, which puts expectant mothers in a tough situation. These women have to decide what is best for them and their baby—to continue taking their SSRI antidepressant (or to start taking it if they are diagnosed with depression during their pregnancy), or to take the risk of stopping medication but potentially suffering from depression during the pregnancy.

It should be noted that no one—pregnant or not—should discontinue use of an antidepressant without first speaking to a doctor.

Those women who have taken an SSRI during their pregnancy—most likely without any idea that there was even a reported potential for birth defects—are now concerned that their children's birth defects might be related to their use of an antidepressant. They watch helplessly as their infants undergo surgeries that even adults would have difficulty with. Infants as young as only a few months old are put through heart surgeries and other medical procedures in the hope that their lives can be saved.

And, of course, there are medical bills associated with all of these procedures, tests and medications—medical bills that these families did not expect and, in some cases, cannot afford.

So the medical community debates about whether or not SSRIs are harmful to unborn babies and pregnant women, and their children, are left in the middle, without answers either way. Those women who took SSRIs while pregnant and have children with birth defects are left to ask whether or not those defects were caused by the medications.

Sarah H. (not her real name) writes to LawyersandSettlements about her 4-year-old daughter who was born with PPHN and had a 5 cm hole in her heart. The little girl is legally blind, fed by feed pump and suffers from severe obstructive sleep apnea. Sarah says she took an SSRI during the early stages of her pregnancy. Now, all she can do is ask if that SSRI may have caused her daughter's medical problems.