Among these women, 91 percent had no or very mild symptoms of depression, about 7 percent had symptoms of depression but did not take SSRIs, and just over 1 percent were depressed and used SSRIs during pregnancy.
Women who were depressed but did not take SSRIs tended to have babies that had smaller bodies and heads, while women who used SSRIs tended to have infants with smaller heads but not smaller bodies, the study found.
Children of mothers using SSRIs had less head-circumference growth than children of depressed mothers not treated with SSRIs, although these babies also showed a reduced growth of head circumference.
Fetal head circumference may be an indicator of brain weight, and small head size in infants from birth to 4 weeks of age may be predictive of behavioral problems and psychiatric disorders, the researchers noted.
However, "we must be careful not to infer an association of SSRI use in pregnancy with future developmental problems," the researchers stated in their report.
In addition, the investigators found that children of depressed mothers who did not use SSRIs were born slightly later than usual (about one day). Children of mothers who used SSRIs were twice as likely to be born preterm.
This study shows only an association and not a cause-and-effect relationship between SSRIs, depression and birth outcomes, El Marroun cautioned.
The findings add to the growing literature on the risks associated with SSRIs and depression, and suggest that the choices women make about using SSRIs during pregnancy are difficult, said Michael O'Hara, a professor of psychology at the University of Iowa in Iowa City.
"One thing is disturbing about the paper," O'Hara said. "It ignores the fact that antidepressant medication is only one approach to the treatment of depression during pregnancy or any other time."
There is evidence that psychological treatments for depression can be used during pregnan
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