Mental health disorders are the largest contributor to maternal mortality in the U.S. Pregnancy can worsen existing depression, anxiety, and other psychiatric disorders. Untreated or undertreated depression during pregnancy carries health risks, such as suicide, preterm birth, preeclampsia, and low birth weight. Available data show that selective serotonin reuptake inhibitor (SSRI) antidepressant use during pregnancy is not associated with congenital anomalies, fetal growth problems, or long-term developmental problems.
Researchers from the University of Pennsylvania in Philadelphia examined de-identified records from Independence Blue Cross, a state-based private insurance database, of 3,983 patients who gave birth between January 1, 2023, and December 31, 2024. All patients were diagnosed with depression/anxiety before pregnancy and had an active prescription for an SSRI or an SNRI (serotonin norepinephrine reuptake inhibitor) antidepressant three months before pregnancy.
The study’s researchers found no difference in outpatient or emergency room visits for mental health indications prior to pregnancy between patients who continued taking their antidepressant and those who did not. However, patients who stopped taking their antidepressant therapy during pregnancy had an almost two-fold higher risk of having a mental health emergency (such as suicide risk, substance overdose, and psychosis), with peaks in the first and ninth months of pregnancy.
“These findings, while not entirely surprising to those who work with pregnant patients who suffer from mental health conditions, are so important to consider for maternal health policy,” said lead researcher Kelly B. Zafman, MD, MSCR, a maternal-fetal medicine fellow at the Hospital of the University of Pennsylvania. “This work underscores the need to take pregnant patients’ mental health seriously and to offer the full range of treatment options — including medications when clinically appropriate. Confronting the maternal mental health crisis is essential to reducing maternal morbidity and mortality in the United States.”
Reference:
Study: Discontinuing antidepressants in pregnancy nearly doubles risk of mental health emergencies, Society for Maternal-Fetal Medicine, Meeting: 2026 Pregnancy Meeting™
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