Cases where pregnant mothers have a history of psychiatric conditions and are in the routine of taking medications, often are at crossroads when it comes to deciding whether or not to continue the course during pregnancy. How it would affect the baby is a major concern for every mother:
- Antidepressants during pregnancy can cause congenital anomalies or stillbirths
- Certain Epilepsy drugs unliked from birth defects
1. Antidepressants during pregnancy can cause congenital anomalies or stillbirths
Academics at Swansea University who carried out a dose-response analysis on pregnant women taking antidepressants found out that Pregnant women who take a specific type of antidepressant in early pregnancy have a small but significantly greater risk of having babies with major congenital anomalies (birth defects) or stillbirths compared with those who did not take these antidepressants.
The type of anti-depressant found to be harmful were selective serotonin reuptake inhibitors, known as SSRIs,
The research found that 7 in 200 pregnancies where SSRIs were prescribed had an adverse outcome of stillbirth or a baby with a major congenital anomaly, but excluding SSRIs downsized the rate to 6 in 200. The team says that this seemingly small risk is of public health importance due to the severity of the outcome.
Of course, this result cannot mean that the mothers should stop taking the medicine, as it can cause equally intense problems. But the study sends a message to health care professionals to be very mindful of the risk and to take the appropriate action to ensure that women are given proper care before, during and after pregnancy to minimize the risks of congenital anomalies linked to SSRIs.
Avoid the prescription or try it in the least quantities possible. Also, proper evaluation of pre-pregnancy care should be done in cases where SSRIs are prescribed and ensure that appropriate levels of neonatal care are available to at-risk women.
Women should not stop taking SSRIs without consultations with their doctor on the benefits and risks of SSRIs and alternative non-pharmacological therapies, as affluent mental health is also important for both mother and child.
2.Certain Epilepsy drugs unliked from birth defects
When it comes to the case of epilepsy, it is rather important that women continue their medication during pregnancy, for their health. Not only that, but research for more than two decades have shown that children exposed to these medications in the womb can be at a higher risk of having a malformation or birth defect.
But this recent joint study conducted by researchers from the universities of Liverpool and Manchester has come up with a breather – the study could successfully attach a certain group of epilepsy medication to the birth defects, and excluding many others from causing the risk.
The majority of epilepsy -affected women with will be required to continue anti-epileptic drug treatment during a pregnancy and therefore the only step possible is to carefully choose treatment methods and collaboratively find a balance between securing maternal health whilst minimizing fetal risk.
It was found that exposure in the womb to sodium valproate based medications were associated with a 10% chance of the child having a birth defect, a percentage that rose as the dose of the drug increased.
But the hearty aspect of the study is that it also found that children exposed to lamotrigine or levetiracetam were not found to be at an increased risk of significant birth defects and had lower risks when compared to the children exposed to drugs such as carbamazepine, phenytoin or topiramate.
This is a really important result that should be considered during consultations about epilepsy treatment choices for pregnant women or those of childbearing potential.
As per the current evidence, levetiracetam and lamotrigine appear to be the AEDs associated with the lowest level of risk.