The use of antidepressants in pregnancy: focus on maternal risks

Studies have consistently reported a decrease in the use of antidepressants during pregnancy compared with the pre-pregnancy period. Multiple recent studies have focused on the potential fetal risks of selective serotonin reuptake inhibitors (SSRIs) and selective norepinephrine reuptake inhibitors (SNRIs), with very little attention paid to maternal risks. The maternal risks of these medications are the focus of this review. Untreated depression is associated with increased risks of maternal morbidity, both somatic and psychiatric. In contrast, use of antidepressants has been associated with increased risks of hypertension, preeclampsia, and bleeding. In this review we present the evidence for maternal risks in an attempt to develop a risk-benefit ratio.