The commonly held belief that the hormonal changes that occur during pregnancy protect women from depression is incorrect, says a new study in the Journal of the American Medical Association. The researchers add that women with major depression who discontinue antidepressant medication during pregnancy are at risk of relapse.
The researchers, from Massachusetts General Hospital and Harvard Medical School, conducted the study to determine the risk of relapse in pregnant women with major depression who discontinued antidepressant medication close to conception compared with those who continued antidepressant treatment. Two hundred pregnant women with a history of major depression prior to pregnancy were enrolled in the study.
The study found that two-thirds (68 percent) of the women who ceased treatment relapsed during pregnancy. The first trimester appeared to be the time of greatest risk of relapse. Among the women who maintained their antidepressant medication throughout the pregnancy, only 26 percent relapsed.
With the increasing use of antidepressants in the community, the researchers said a growing number of women must make a decision regarding the continued use of antidepressants during pregnancy. Women need to weigh up the relative risks of prenatal exposure to medication on the one hand and the risk of relapse on the other, they added.
Quantification of these risks was important and; "such information can also help to refine treatment guidelines for women with a history of depression who are planning to conceive or who experience mood disorders during pregnancy," the researchers concluded.
Source: Journal of the American Medical Association