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Medical News & Perspectives
December 9, 2009

No Easy Answers for Physicians Caring for Pregnant Women With Depression

JAMA. 2009;302(22):2413-2420. doi:10.1001/jama.2009.1762

Prompted by growing evidence that pregnant women face a higher risk of fetal problems both with the use of selective serotonin reuptake inhibitors (SSRIs) and with untreated depression, experts from the American College of Obstetricians and Gynecologists (ACOG) and the American Psychiatric Association (APA) are offering physicians a nuanced set of guidelines that emphasize an individualized approach.

Between 10% and 20% of women experience depression during pregnancy, according to the March of Dimes, and the use of antidepressant medications in this population for at least some period during pregnancy more than doubled in recent years, from 5.7% of pregnancies in 1993 to 13.4% in 2003 (Cooper WO et al. Am J Obstet Gynecol. 2007;196[6]:544e). Yet even as more women and their physicians recognize the importance of treating depression for the well-being of both mother and child, they face difficult choices when considering whether medication use is appropriate.