"Those risks for the pregnant mom," Dr Kruszewski warns, "may include antidepressant withdrawal, akathisia or rapid mood swings."
"For the fetus," he says, "the overwhelming worry is congenital malformations, resulting in complications for both mother and child.”
SSRI makers have known about the fetal harm of SSRIs for over a decade. As far back as 1996, the New England Journal of Medicine reported a study that showed higher rates of premature delivery, low birth weight, admissions to intensive care units, and poor neonatal adaptation, including respiratory and feeding difficulties, and jitteriness, in children born to women who took Prozac during pregnancy.
In 2004, the FDA revised SSRI labels to warn that some infants had developed problems requiring prolonged hospitalization, respiratory support, and tube feeding. Three FDA advisories have been issued on Paxil since December 2005, and the drug's pregnancy category has been raised from C to D, meaning there is positive evidence of fetal harm.
In February 2006, the Archives of Pediatrics & Adolescent Medicine, reported that roughly one-third of infants exposed to SSRIs showed signs of withdrawal such as high-pitched crying, tremors, gastrointestinal problems and disturbed sleep, with 13% severe.
The April 2006, American Journal of Obstetrics and Gynecology, reported that taking SSRIs doubled the mother's risk of delivering a stillborn infant and increased the risk of premature delivery, underweight babies, and seizures.
In July 2006, the FDA issued an advisory warning that infants exposed to SSRIs were six times more likely to develop the often fatal lung disorder, persistent pulmonary hypertension (PPH), than infants who were not exposed.
The October 2006 edition of Epidemiology reported that women who took SSRIs during the second or third month of pregnancy had nearly two times the risk of having babies with congenital malformations, with the most common being cardiovascular malformations in 29%, muscle and bone malformations in 31%, and 14% had digestive malformations.
Meanwhile, the Sun reports that Good Samaritan screened 1,262 patients in 2006, and found 18% at risk for postpartum depression. Not a bad catch for SSRI makers and it can only get better when the plan for "universal screening" kicks in.
One of the latest recruitment scams involves expanding the postpartum depression market by 10% simply by including the husbands. According to an August 2006 study in Pediatrics, about 10% of fathers suffer from moderate or severe postpartum depression.
"Postpartum depression in fathers was strikingly high and more than twice as common than in the general adult male population in the U.S.," say researchers including Dr James Paulson, of the Center for Pediatric Research at the Eastern Virginia Medical School.
As a result, the authors advise, pediatricians must make a greater effort to screen moms and dads for postpartum depression.
However, this appears to be a case of the dueling researchers in medical journals because in December 2006, a Danish study in the Journal of American Medical Association, found that first-time mothers were at an increased risk for mental disorders but fathers were not.
This 32-year study included more than 2.3 million people, and roughly one out of 1,000 first-time mothers were admitted to a hospital with a mental illness within one year, and most were admitted within the first three months after birth. But among fathers, only 0.37 of 1,000 births resulted in a mental disorder, which the authors noted, was comparable to men without children or men with an older infant.
"This may indicate that the causes of postpartum mental disorders are more strongly linked to an altered physiological process related to pregnancy and childbirth than psychosocial aspects of motherhood," said study author Trine Munk-Olsen of the University of Aarhus, Denmark.
This is indeed the case, according to Dr Jackson. "The third trimester," she says, "is a wild time for the mother, in terms of hormonal changes that occur within her system largely because of the hormones that are produced in the placenta."
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