Advertisement

Depression During Pregnancy and Postpartum

  • Madeleine BeckerEmail author
  • Tal Weinberger
  • Ann Chandy
  • Sarah Schmukler
Complex Medical-Psychiatric Issues (MB Riba, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Complex Medical-Psychiatric Issues

Abstract

Depression is a common complication of pregnancy and the postpartum period. There are multiple risk factors for peripartum mood disorders, most important of which is a prior history of depression. Both depression and antidepressant medications confer risk upon the infant. Maternal depression has been associated with preterm birth, low birth weight, fetal growth restriction, and postnatal cognitive and emotional complications. Antidepressant exposure has been associated with preterm birth, reductions in birth weight, persistent pulmonary hypertension, and postnatal adaptation syndrome (PNAS) as well as a possible connection with autism spectrum disorder. Paroxetine has been associated with cardiac malformations. Most antidepressant medications are excreted in low levels in breast milk and are generally compatible with breastfeeding. The use of antidepressants during pregnancy and postpartum must be weighed against the risk of untreated depression in the mother.

Keywords

Depression Pregnancy Postpartum depression Antidepressants Lactation 

Notes

Compliance with Ethical Standards

Conflict of Interest

Madeleine Becker, Tal Weinberger, Ann Chandy, and Sarah Schmukler declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as: • Of Importance •• Of Major importance

  1. 1.
    Committee on Obstetric Practice. The American College of Obstetricians and Gynecologists Committee Opinion no. 630. Screening for perinatal depression. Obstet Gynecol. 2015;125(5):1268–71.CrossRefGoogle Scholar
  2. 2.
    ACOG Committee. Clinical Management Guidelines for Obstetrician–Gynecologists: use of psychiatric medications during pregnancy and lactation. ACOG Practice Bulletin No. 92. Obstet Gynecol. 2008;111(4):1001–20.CrossRefGoogle Scholar
  3. 3.
    Yonkers KA, Wisner KL, Stewart DE, et al. The management of depression during pregnancy: a report from the American Psychiatric Association and the American College of Obstetricians and Gynecologists. Gen Hosp Psychiatry. 2009;31(5):403–13.PubMedCentralPubMedCrossRefGoogle Scholar
  4. 4.
    Wisner KL, Sit DK, McShea MC, Rizzo DM, Zoretich RA, Hughes CL, et al. Onset timing, thoughts of self-harm, and diagnoses in postpartum women with screen-positive depression findings. JAMA Psychiatry. 2013;70(5):490–8. doi: 10.1001/jamapsychiatry.2013.87.PubMedCentralPubMedCrossRefGoogle Scholar
  5. 5.
    Lindahl V, Pearson JL, Colpe L. Prevalence of suicidality during pregnancy and the postpartum. Arch Womens Ment Health. 2005;8(2):77–87.Google Scholar
  6. 6.
    Raisanen S, Lehto SM, et al. Risk factors for perinatal outcomes of major depression during pregnancy: a population-based analysis during 2002-2010 in Finland. BMJ Open. 2014;4(11):e004883.PubMedCentralPubMedCrossRefGoogle Scholar
  7. 7.
    Cohen LS, Altshuler LL, Harlow BL, et al. Relapse of major depression during pregnancy and in women who maintain or discontinue antidepressant treatment. JAMA. 2006;295(5):499–507.PubMedCrossRefGoogle Scholar
  8. 8.
    Szegda K, Markenson G, Bertone-Johnson ER, Chasan-Taber L. Depression during pregnancy: a risk factor for adverse neonatal outcomes? A critical review of the literature. J Matern Fetal Neonatal Med. 2014;27(9):960–7.PubMedCrossRefGoogle Scholar
  9. 9.
    Grigoriadis S, VonderPorten EH, Mamisahvili L, et al. The impact of maternal depression during pregnancy on perinatal outcomes: a systematic review and meta-analysis. J Clin Psychiatry. 2013;74(4):e321–41.PubMedCrossRefGoogle Scholar
  10. 10.
    Ciesielski TH, Marsit CJ, Williams SM. Maternal psychiatric disease and epigenetic evidence suggest a common biology for poor fetal growth. BMC Pregnancy Childbirth. 2015;15:192. doi: 10.1186/s12884-015-0627-8.PubMedCentralPubMedCrossRefGoogle Scholar
  11. 11.
    Davalos DB, Yadon CA, Tregellas HC. Untreated prenatal maternal depression and the potential risks to offspring: a review. Arch Womens Ment Health. 2012;15(1):1–14. doi: 10.1007/s00737-011-0251-1.PubMedCrossRefGoogle Scholar
  12. 12.
    Grote NK, Bridge JA, Gavin AR, Melville JL, Iyengar S, Katon WJ. A meta-analysis of depression during pregnancy and the risk of preterm birth, low birth weight, and intrauterine growth restriction. Arch Gen Psychiatry. 2010;67(10):1012–24.PubMedCentralPubMedCrossRefGoogle Scholar
  13. 13.
    Iliadis SI, Comasco E, Sylvén S, Hellgren C, Sundström Poromaa I, Skalkidou A. Prenatal and postpartum evening salivary cortisol levels in association with peripartum depressive symptoms. PLoS One. 2015;10(8):e0135471. doi: 10.1371/journal.pone.0135471.eCollection2015.PubMedCentralPubMedCrossRefGoogle Scholar
  14. 14.
    Federenko IS, Wadhwa PD. Women’s mental health during pregnancy influences fetal and infant developmental and health outcomes. CNS Spectr. 2004;9(3):198–206.PubMedGoogle Scholar
  15. 15.
    Oberlander TF, Weinberg J, Papsdorf M, Grunau R, Misri S, Devlin AM. Prenatal exposure to maternal depression, neonatal methylation of human glucocorticoid receptor gene (NR3C1) and infant cortisol stress responses. Epigenetics. 2008;3:97–106.PubMedCrossRefGoogle Scholar
  16. 16.
    Wisner KL, Sit DK, Hanusa BH, Moses-Kolko EL, Bogen DL, Hunker DF, et al. Major depression and antidepressant treatment: impact on pregnancy and neonatal outcomes. Am J Psychiatry. 2009;166(5):557–66. doi: 10.1176/appi.ajp.2008.08081170.PubMedCentralPubMedCrossRefGoogle Scholar
  17. 17.
    Pearson RM, Melotti R, Heron J, Joinson C, Stein A, Ramchandani PG, et al. Disruption to the development of maternal responsiveness? The impact of prenatal depression on mother-infant interactions. Infant Behav Dev. 2012;35(4):613–26. doi: 10.1016/j.infbeh.2012.07.020.PubMedCrossRefGoogle Scholar
  18. 18.
    Robertson E, Grace S, Wallington T, et al. Antenatal risk factors for postpartum depression: a synthesis of recent literature. Gen Hosp Psychiatry. 2004;26:289–95.PubMedCrossRefGoogle Scholar
  19. 19.
    Beck CT. Predictors of postpartum depression: an update. Nurs Res. 2001;50(5):275–85.PubMedCrossRefGoogle Scholar
  20. 20.
    Gaillard A, Le Strat Y, Mandelbrot L, et al. Predictors of postpartum depression: prospective study of 264 women followed during pregnancy and postpartum. Psychiatry Res. 2014;215(2):341–6.PubMedCrossRefGoogle Scholar
  21. 21.
    Kimmel M, Hess E, Roy PS. Family history, not lack of medication use, is associated with the development of postpartum depression in a high-risk sample. Arch Womens Ment Health. 2015;18:113–21.PubMedCrossRefGoogle Scholar
  22. 22.
    Bloch M, Rotenberg N, Koren D, Klein E. Risk factors associated with the development of postpartum mood disorders. J Affect Disord. 2005;88(1):9–18.PubMedCrossRefGoogle Scholar
  23. 23.
    Davanzo R, Copertino M, DeCunto A, et al. Antidepressant drugs and breastfeeding: a review of the literature. Breastfeed Med. 2011;6(2):89–98.PubMedCrossRefGoogle Scholar
  24. 24.
    Dubber S, Reck C, Müller M, Gawlik S. Postpartum bonding: the role of perinatal depression, anxiety and maternal-fetal bonding during pregnancy. Arch Womens Ment Health. 2015;18(2):187–95. doi: 10.1007/s00737-014-0445-4.PubMedCrossRefGoogle Scholar
  25. 25.
    McLearn KT, Minkovitz CS, Strobino DM, Marks E, Hou W. Maternal depressive symptoms at 2 to 4 months post partum and early parenting practices. Arch Pediatr Adolesc Med. 2006;160(3):279–84.PubMedCrossRefGoogle Scholar
  26. 26.
    Paulson JF, Dauber S, Leiferman JA. Individual and combined effects of postpartum depression in mothers and fathers on parenting behavior. Pediatrics. 2006;118(2):659–68.PubMedCrossRefGoogle Scholar
  27. 27.
    Dias CC, Figueiredo B. Breastfeeding and depression: a systematic review of the literature. J Affect Disord. 2015;171:142–54. doi: 10.1016/j.jad.2014.09.022.PubMedCrossRefGoogle Scholar
  28. 28.
    Hatton DC, Harrison–Hohner J, Coste S, et al. Symptoms of postpartum depression and breastfeeding. J Hum Lac. 2005;21(44):444–9.CrossRefGoogle Scholar
  29. 29.
    Feldman R, Granat A, Pariente C, et al. Maternal depression and anxiety across the postpartum year and infant social engagement, fear regulation, and stress reactivity. J Am Acad Child Adolesc Psychiatry. 2009;48(9):919–27.PubMedCrossRefGoogle Scholar
  30. 30.
    Grace SL, Evindar A, Stewart DE. The effect of postpartum depression on child cognitive development and behavior: a review and critical analysis of the literature. Arch Women s Mental Health. 2003;6:263–74.CrossRefGoogle Scholar
  31. 31.
    Pilowsky DJ, Wickramaratne PJ, Rush AJ, Hughes CW, Garber J, Malloy E, et al. Children of currently depressed mothers: a STAR*D ancillary study. J Clin Psychiatry. 2006;67(1):126–36.PubMedCrossRefGoogle Scholar
  32. 32.
    Biederman J, Faraone SV, Hirshfel-Becker DR, Friedman D, Robin JA, Rosenbaum JF. Patterns of psychopathology and dysfunction in high-risk children of parents with panic disorder and major depression. Am J Psychiatry. 2001;158(1):59–7.CrossRefGoogle Scholar
  33. 33.
    Berle JO, Spigset O. Antidepressant use during breastfeeding. Curr Womens Health Rev. 2011;7:28–34.PubMedCentralPubMedCrossRefGoogle Scholar
  34. 34.
    Fihrer I, McMahon CA, Taylor AJ. The impact of postnatal and concurrent maternal depression on child behavior during the early school years. J Affect Disord. 2009;119:116–23.PubMedCrossRefGoogle Scholar
  35. 35.
    Werner E, Miller M, Osborne LM, Kuzava S, Monk C. Preventing postpartum depression: review and recommendations. Arch Womens Ment Health. 2015;18(1):41–60.PubMedCentralPubMedCrossRefGoogle Scholar
  36. 36.
    Sokol LE, Epperson CN, Barber JP. Preventing postpartum depression: a meta-analytic review. Clin Psychol Rev. 2013;33(8):1205–17.CrossRefGoogle Scholar
  37. 37.
    USPTF. Final recommendation statement; depression in adults: screening. J Am Med Assoc. 2016;315(4):380–7Google Scholar
  38. 38.•
    Byatt N, Deligiannidis KM, Freeman MP. Antidepressant use in pregnancy: a critical review focused on risks and controversies. Acta Psychiatr Scand. 2012:1–21. This is a large critical, comprehensive review examining multiple outcomes on teratogenicity, postnatal adaptation syndrome, and persistent pulmonary hypertension.Google Scholar
  39. 39.
    Suri R, Lin AS, et al. Acute and long-term behavioral outcomes of infants and children exposed in utero to either maternal depression or antidepressants: a review of the literature. J Clin Psychiatr. 2014;75(10):e1142–52.CrossRefGoogle Scholar
  40. 40.
    Grigoriadis S. The effects of antidepressant medications on mothers and babies. J Popul Ther Clin Pharmacol. 2014;21(3):e533–41.PubMedGoogle Scholar
  41. 41.
    Drug labelling and pregnancy. Lancet. 2014 Dec 13;384(9960):2084. doi:  10.1016/S0140-6736(14)62356-4.
  42. 42.
    Ramoz LL, Patel Shori NM. Recent changes in pregnancy and lactation labeling: retirement of risk categories. Pharmacotherapy. 2014;34(4):389–95.PubMedCrossRefGoogle Scholar
  43. 43.
    Food and Drug Administration, HHS. Content and format of labeling for human prescription drug and biological products; requirements for pregnancy and lactation labeling. Final rule. Fed Regist. 2014;79(233).Google Scholar
  44. 44.
    Louik C, Lin A, Werler M, et al. First-trimester use of selective serotonin-reuptake inhibitors and the risk of birth defects. N Engl J Med. 2007;356(26):2675–83.PubMedCrossRefGoogle Scholar
  45. 45.
    Grigoriadis S, VonderPorten EH, Mamisashvili L, et al. Antidepressant exposure during pregnancy and congenital malformations: is there an association? A systemic review and meta-analysis of the best evidence. J Clin Psychiatry. 2013;74(4):e293–308.PubMedCrossRefGoogle Scholar
  46. 46.
    Kallen BA, Otterblad OP. Maternal use of selective serotonin-reuptake inhibitors in early pregnancy and infant congenital malformations. Birth Defects Res A Clin Mol Teratol. 2007;79(4):301–8.PubMedCrossRefGoogle Scholar
  47. 47.
    Greene MF. Teratogenicity of SSRIs—serious concern or much ado about little? N Engl J Med. 2007;356:2732.PubMedCrossRefGoogle Scholar
  48. 48.
    Yonkers KA, Blackwell KA, Glover J, Forray A. Antidepressant use in pregnant and postpartum women. Annu Rev Clinc Psychol. 2014;10:369–92.CrossRefGoogle Scholar
  49. 49.
    Furu K, Kieler H, Haglund B, et al. Selective serotonin reuptake inhibitors and venlafaxine in early pregnancy and risk of birth defects: population based cohort study and sibling design. BMJ. 2015;350:1798. 1-9.Google Scholar
  50. 50.
    Alwan S, Reefhuis J, Rasmussen SA, for National Birth Defects Prevention Study, et al. Use of selective serotonin-reuptake inhibitors in pregnancy and the risk of birth defects. N Engl J Med. 2007;356(26):2684–92.PubMedCrossRefGoogle Scholar
  51. 51.
    Kendall-Tackett K, Hale TW. The use of antidepressants in pregnant and breastfeeding women: a review of recent studies. J Hum Lact. 2010;26(2):187–95.PubMedCrossRefGoogle Scholar
  52. 52.
    Wurst KE, Poole C, Ephross SA, et al. First trimester paroxetine use and the prevalence of congenital, specifically cardiac, defects: a meta-analysis of epidemiological studies. Birth Defects Res A Clin Mol Teratol. 2010;88(3):159–70.PubMedCrossRefGoogle Scholar
  53. 53.
    Bakker MK, Kerstjens-Fredierikse WS, Buys CH, et al. First trimester use of paroxetine and congenital heart defects: a population-based case-control study. Birth Defects Res A Clin Mol Teratol. 2010;88(2):94–100.PubMedGoogle Scholar
  54. 54.
    Cole JA, Ephross SA, Cosmatos IS, et al. Paroxetine in the first trimester and the prevalence of congenital malformations. Pharmacoepidemiol Drug Saf. 2007;16(10):1075–85.PubMedCrossRefGoogle Scholar
  55. 55.
    Reis M, Kallen B. Delivery outcome after maternal use of antidepressant drugs in pregnancy: an update using Swedish data. Psychol Med. 2010;40(10):1723–33.PubMedCrossRefGoogle Scholar
  56. 56.
    Tuccori M. Safety concerns associated with the use of serotonin reuptake inhibitors and other serotonergic/noradrenergic antidepressant sure pregnancy: a review. Clin Ther. 2009;31:1426–53.PubMedCrossRefGoogle Scholar
  57. 57.
    Einarson A, Pistelli A, DeSantis M, et al. Evaluation of the risk of congenital cardiovascular defects associated with the use of paroxetine during pregnancy. Am J Psychiatry. 2008;165(6):749–52.PubMedCrossRefGoogle Scholar
  58. 58.
    Davis RL, Rubanowice D, McPhillips H, et al. Risk of congenital malformations and perinatal events among infants exposed to antidepressant medication during pregnancy. Pharmacoepidemiol Drug Saf. 2007;16(10):186–94.CrossRefGoogle Scholar
  59. 59.••
    Huybrechts KF, Palmesten K, Avorn J, et al. Antidepressant use in pregnancy and the risk of cardiac defects. N Engl J Med. 2014;370(25):2397–407. This was a large cohort study with 949,504 pregnant women comparing those who took antidepressants to those who did not, which found no substantial increase in the risk of cardiac malformations attributable to antidepressant use during the first trimester.PubMedCentralPubMedCrossRefGoogle Scholar
  60. 60.
    Einarson A, Boskovic R. Use and safety of antipsychotic drugs during pregnancy. J Psychiatr Pract. 2009;15(3):183–92.PubMedCrossRefGoogle Scholar
  61. 61.
    Gentile S. Early pregnancy exposure to selective serotonin reuptake inhibitors, risks of major structural malformations, and hypothesized teratogenic mechanisms. Expert Opin Drug Metab Toxicol. 2015;1:1–13.Google Scholar
  62. 62.
    Huybrechts KF, Snghani RS, Avorn J, Urato AC. Preterm birth and antidepressant medication use during pregnancy: a systematic review and meta-analysis. PLoS One. 2014;9(3):e92778.PubMedCentralPubMedCrossRefGoogle Scholar
  63. 63.
    Oberlander TF, Warburton W, Misri S, et al. Effects of timing and duration of gestational exposure to serotonin reuptake inhibitor antidepressants: population-based study. Br J Psychiatry. 2008;192:338–43.PubMedCrossRefGoogle Scholar
  64. 64.
    Suri R, Alshuler L, Hellemann G, Burt VK, Aquino A, Mintz J. Effects of antenatal depression and antidepressant treatment on gestational age at birth and risk of preterm birth. Am J Psychiatr. 2007;164(8):1206–13.PubMedCrossRefGoogle Scholar
  65. 65.•
    Ross LE, Grigoriadis S, Mamisashvili L, VonderPorten EH, Roerecke M, Rehm J, et al. Selected pregnancy and delivery outcomes after exposure to antidepressant medication: a systematic review and meta-analysis. JAMA Psychiatry. 2013;70:436–43. A review article looking at selected outcomes after exposure to antidepressant medications; this study showed that there was no association between antidepressant exposures. It also showed that there was an association with low birth weight, but compared to depressed moms without exposure, this was no longer a significant association. There have been adverse outcomes associated with both antidepressant exposure and depression.PubMedCrossRefGoogle Scholar
  66. 66.
    Huang H, Coleman S, Bridge JA, Yonkers K, Katon W. A meta-analysis of the relationship between antidepressant use in pregnancy and the risk of preterm birth and low birth weight. Gen Hosp Psychiatry. 2014;36(1):13–8.PubMedCrossRefGoogle Scholar
  67. 67.
    Sahingoz M, Yuksel G, Karsidag C, Uguz F, Sonmez EO, Annagur BB, et al. Birth weight and preterm birth in babies of pregnant women with major depression in relation to treatment with antidepressants. J Clin Psychopharmacol. 2014;34(2):226–9.PubMedCrossRefGoogle Scholar
  68. 68.
    Rai D, Lee BK, Dalman C, Golding J, Lewis G, Manusson C. Parental depression, maternal antidepressant use during pregnancy, and the risk of autism spectrum disorders: population based case-control study. BMJ. 2013;346:f2059.PubMedCentralPubMedCrossRefGoogle Scholar
  69. 69.
    El Marroun H, Whilte T, Verhulst FC, Tiemeier H. Maternal use of antidepressant or anxiolytic medication during pregnancy and childhood neurodevelopmental outcomes: a systematic review. Eur Child Adolesc Psychiatry. 2014;23(10):973–92.PubMedCrossRefGoogle Scholar
  70. 70.
    Harrington RA, Lee LC, Crum RM, Zimmerman AW, Hertz-Picciotto I. Prenatal SSRI use and offspring with autism spectrum disorder or developmental delay. Pediatrics. 2014;133(5):e1241–8.PubMedCentralPubMedCrossRefGoogle Scholar
  71. 71.
    Croen LA, Grether JK, Yoshida CK, Odouli R, Hendrick V. Antidepressant use during pregnancy and childhood autism spectrum disorders. Arch Gen Psychiatry. 2011;68(11):1104–12.PubMedCrossRefGoogle Scholar
  72. 72.
    Sorensen MJ, Gronborg TK, Christensen J, Parner ET, Vestergaard M, Schendel D, et al. Antidepressant exposure in pregnancy and risk of autism spectrum disorders. Clin Epidemiol. 2013;5:449–59.PubMedCentralPubMedCrossRefGoogle Scholar
  73. 73.
    Kallen Bm KOlausson PO. Maternal use of selective serotonin reuptake inhibitors and persistent pulmonary hypertension of the newborn. Pharmacoepidmiol Drug Saf. 2008;17:801–6.CrossRefGoogle Scholar
  74. 74.
    Huybrecs KF, Bateman BT, Palmsten K, et al. Antidepressant use late in pregnancy and the risk of persistent pulmonary hypertension of the newborn. JAMA. 2015;313(21):2142–51.CrossRefGoogle Scholar
  75. 75.
    Kieler H, Artama M, Anders Engeland A, et al. Selective serotonin reuptake inhibitors during pregnancy and risk of persistent pulmonary hypertension in the newborn: population based cohort study from the five Nordic countries. BMJ 2012; 344. doi:  10.1136/bmj.d8012 (Published 12 January 2012) Cite this as: BMJ 2012;344:d8012
  76. 76.
    Chambers CD et al. Selective serotonin reuptake inhibitors and the risk of persistent pulmonary hypertension of the newborn. N Engl J Med. 2006;354:579–87.PubMedCrossRefGoogle Scholar
  77. 77.
    Eddahibi S, Raffestin B, Hamon M, Adnot S. Is the serotonin transporter involved in the pathogenesis of pulmonary hypertension? J Lab Clin Med. 2002;139:194–201.PubMedCrossRefGoogle Scholar
  78. 78.
    Andrade SE, McPhillips H, Loren D, et al. Antidepressant medication use and risk of persistent pulmonary hypertension of the newborn. Pharmacoepidemiol Drug Saf. 2009;18:246–52.PubMedCrossRefGoogle Scholar
  79. 79.
    Administration USFAD. FDA drug safety communication: selective serotonin reuptake inhibitor (SSRI) antidepressant use during pregnancy and reports of a rare heart and lung condition in newborn babies. 12/4/11 ed2011.Google Scholar
  80. 80.
    Grigoriadis S, Vonderporten EH, Mamisashvili L, Tomlinson G, Dennis CL, Koren G, et al. Prenatal exposure to antidepressants and persistent pulmonary hypertension of the newborn: systematic review and meta-analysis. BMJ. 2014;14:348.Google Scholar
  81. 81.
    Byatt N, Freeman MP. Exposure to selective serotonin reuptake inhibitors in late pregnancy increases the risk of persistent pulmonary hypertension of the newborn, but the absolute risk is low. Evid Based Nurs. 2015;18(1):15–6.PubMedCentralPubMedCrossRefGoogle Scholar
  82. 82.
    Chambers CD, Johnson KA, Dick LM, Feliz RJ, Jones KL. Birth outcomes in pregnant women taking fluoxetine. N Engl J Med. 1996;335(14):1010–5.PubMedCrossRefGoogle Scholar
  83. 83.
    Moses-Kolko EL, Bogen D, Perel J, et al. Neonatal signs after late in utero exposure to serotonin reuptake inhibitors: literature review and implications for clinical applications. JAMA. 2005;293:2372–83.PubMedCrossRefGoogle Scholar
  84. 84.
    Lennestal R, Kallen B. Delivery outcome in relation to maternal use of some recently introduced antidepressants. J Clin Psychopharmacol. 2007;27:607–13.PubMedCrossRefGoogle Scholar
  85. 85.
    Hibbard JU, Wilkins I, Sun L, et al. Respiratory morbidity in late preterm births. JAMA. 2010;304:419–25.PubMedCentralPubMedCrossRefGoogle Scholar
  86. 86.
    Byatt N et al. Antidepressant use in pregnancy: a critical review focused on risks and controversies. Acta Psychiatr Scand. 2013;127:94–114.PubMedCentralPubMedCrossRefGoogle Scholar
  87. 87.
    Einarson A, Bonari L, Voyer-Lavigne S, Addis A, Matsui D, Johnson Y, et al. A multicentre prospective controlled study to determine the safety of trazodone and nefazodone use during pregnancy. Canadian Journal of Psychiatry (Revue Canadienne de Psychiatrie). 2003;48(2):106–10.Google Scholar
  88. 88.
    Einarson TR, Einarson A. Newer antidepressants in pregnancy and rates of major malformations: a meta-analysis of prospective studies. Pharmacoepidemiol Drug Saf. 2005;14(12):823–7.PubMedCrossRefGoogle Scholar
  89. 89.
    Winterfeld U et al. Pregnancy outcome following maternal exposure to mirtazapine: a multicenter, prospective study. J Clin Psychopharmacol. 2015;35(3):250–9.PubMedCrossRefGoogle Scholar
  90. 90.
    Djulus J et al. Exposure to mirtazapine during pregnancy: a prospective and comparative study of birth outcomes. J Clin Psych. 2006;67(8):1280–4.CrossRefGoogle Scholar
  91. 91.
    GlaxoSmithKline. The Bupropion Pregnancy Registry final report. (2008): http://pregnnacy-registry.gsk.com/documents/bup_report_final-2008.pdf.
  92. 92.
    Alwan S, Reefhuis J, Botto LD, et al. Maternal use of bupropion and risk for congenital heart defects. Am J Obstet Gynecol. 2010;203(1):52.e1–6.CrossRefGoogle Scholar
  93. 93.
    Chun-Fai-Chan B, Koren G, et al. Pregnancy outcome of women exposed to bupropion during pregnancy: a prospective comparative study. Am J Obstet Gynecol. 2005;192:932–6.PubMedCrossRefGoogle Scholar
  94. 94.
    Howard LM, Molyneux E, Dennis CL, Tamsen R, Stein A, Milgrom J. Non-psychotic mental disorders in the perinatal period. Perinatal Mental Health The Lancet. 2014;384(9956):15–21.Google Scholar
  95. 95.
    Anderson PO, Pochop SL, Manoguerra AS. Adverse drug reactions in breastfed infants: less than imagined. Clin Pediatr. 2003;42:325–40.CrossRefGoogle Scholar
  96. 96.
    Eberhard-Gran M, Eskild A, Opjordsmoen S. Use of psychotropic medications in treating mood disorders during lactation: practical recommendations. CNS Drugs. 2006;20(3):187–98.PubMedCrossRefGoogle Scholar
  97. 97.
    Lanza DiScalea T, Wisner KL. Antidepressant medication use during breastfeeding. Clin Obstet Gynecol. 2009;52(3):483–97.CrossRefGoogle Scholar
  98. 98.
    Lester BM, Cucca J, Andreozzi L, et al. Possible association between fluoxetine hydrochloride and colic in an infant. J Am Acad Child Adolesc Psychiatry. 1993;32:1253–5.PubMedCrossRefGoogle Scholar
  99. 99.
    Kristensen JH, Ilett KF, Hackett LP, Yapp P, Paech M, Begg EJ. Distribution and excretion of fluoxetine and norfluoxetine in human milk. Br J Clin Pharmacol. 1999;48(4):521–7.PubMedCentralPubMedCrossRefGoogle Scholar
  100. 100.
    Weissman AM, Levy BT, Hartz AJ, et al. Pooled analysis of antidepressant levels in lactating mothers, breast milk, and nursing infants. Am J Psychiatry. 2004;161:1066–78.PubMedCrossRefGoogle Scholar
  101. 101.
    Field T. Breastfeeding and antidepressants. Infant Behav Dev. 2008;31(3):481–7.PubMedCentralPubMedCrossRefGoogle Scholar
  102. 102.
    Gentile S. Use of contemporary antidepressants during breastfeeding: a proposal for a specific safety index. Drug Saf. 2007;30(2):107–21.PubMedCrossRefGoogle Scholar
  103. 103.
    Potts AL, Young KL, Carter BS, Shenai JP. Necrotizing enterocolitis associated with in utero and breast milk exposure to the selective serotonin reuptake inhibitor, escitalopram. J Perinatol. 2007;27:120–2.PubMedCrossRefGoogle Scholar
  104. 104.
    Chad L, Pupco A, Bozzo P, Koren G. Update on antidepressant use during breastfeeding. Can Fam Physician. 2013;59:633–4.PubMedCentralPubMedGoogle Scholar
  105. 105.
    Andrade C. The safety of duloxetine during pregnancy and lactation. J Clin Psychiatry. 2014;75(12):e1423–7.PubMedCrossRefGoogle Scholar
  106. 106.
    Rampono J, Teoh S, Hackett LP et al. Estimation of desvenlafaxine transfer into milk and infant exposure during its use in lactating women with postnatal depression. Arch Womens Ment Health. 2011;14:49–53.Google Scholar
  107. 107.
    Baab SW, Peindl KS, Piontek CW, Wisner KL. Serum bupropion levels in 2 breastfeeding mother-infant pairs. J Clin Psychiatry. 2002;63(10):910–1.PubMedCrossRefGoogle Scholar
  108. 108.
    Haas J, Kaplan C, Barenboim D, et al. Bupropion in breast milk: an exposure assessment for potential treatment to prevent post-partum tobacco use. Tob Control. 2004;13(1):52–6.PubMedCentralPubMedCrossRefGoogle Scholar
  109. 109.
    Chaudron LH, Schoenecker CJ. Bupropion and breastfeeding: a case of a possible infant seizure. J Clin Psychiatry. 2004;65(6):881–2.PubMedCrossRefGoogle Scholar
  110. 110.
    Aichhorn W, Whitworth AB, Weiss U, Stuppaeck C. Letters to the editor: Mirtazapine and breastfeeding. Am J Psychiatry. 2004;161(12):2325.PubMedCrossRefGoogle Scholar
  111. 111.
    Klier CM, Moussaheb N, Lee A, Zernig G. Letters to the editor: Mirtazapine and breastfeeding: maternal and infant plasma levels. Am J Psychiatry. 2007;164(2):348–9.PubMedCrossRefGoogle Scholar
  112. 112.
    Kristensen JH, Ilett KF, Rampono J, et al. Transfer of the antidepressant mirtazapine into breast milk. Br J Clin Psychiatr. 2007;63(3):322–7.Google Scholar
  113. 113.
    Tonn P, Reuter SC, Hiemke C, Dahmen N. High mirtazapine plasma levels in infant after breast feeding: case report and review of the literature. J Clin Psychopharmacol. 2009;29(2):191–2.PubMedCrossRefGoogle Scholar
  114. 114.
    Verbeeck RK, Ross SG, McKenna EA. Excretion of trazodone in breast milk. Br J Clin Pharmacol. 1986;22(3):367–70.PubMedCentralPubMedCrossRefGoogle Scholar
  115. 115.
    Orsolini L, Bellantuono C. Serotonin reuptake inhibitors and breastfeeding: a systemic review. Hum Psychopharmacol Clin Exp. 2015;30:4–20.CrossRefGoogle Scholar
  116. 116.
    Burt VK, Suri R, Altshuler L, et al. The use of psychotropic medications during breastfeeding. Am J Psychiatry. 2001;158:1001–9.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Madeleine Becker
    • 1
    Email author
  • Tal Weinberger
    • 2
  • Ann Chandy
    • 1
  • Sarah Schmukler
    • 1
  1. 1.Department of Psychiatry and Human BehaviorThomas Jefferson University HospitalPhiladelphiaUSA
  2. 2.Department of Psychiatry and Human BehaviorThomas Jefferson University HospitalPhiladelphiaUSA

Personalised recommendations