Continuing Antidepressants During Pregnancy May Reduce Postpartum Depression Risk: Study
Maintaining antidepressant therapy during pregnancy may significantly lower the risk of postpartum depression in women with a history of depression, according to a study published in the American Journal of Obstetrics and Gynecology. The findings support the continued use of antidepressants during pregnancy in appropriately selected patients, particularly those at high risk of depressive relapse, while emphasizing the need for individualized risk-benefit assessment. The study was conducted by Kathryn K. and colleagues.
To ascertain the association between antidepressant medication continuation in pregnancy and postpartum psychiatric outcome, researchers carried out a retrospective cohort analysis at a large, multi-ethnic community-based health care organization. This study analyzed medical records of adult patients 18 years old or above with a history of depression and live births between 2010 and 2019, who filled antidepressant prescription one year before their last menstrual period. Patients with bipolar, psychotic, or active substance abuse disorders were not included in the study.
Exposure was determined based on prescription fill history and the participants were divided into three groups: continuation of antidepressants, stoppage and then restarting, and stoppage of antidepressants during pregnancy. Postpartum depression was defined as International Classification of Diseases (ICD) diagnosis or PHQ-9 scores of 10 or more during one-year postpartum period, with PHQ-9 being categorized as none-minimal (0-4), mild (5-9), moderate (10-14), moderately-severe (15-19), and severe (20 or more).
Key findings:
- Among the entire cohort of 6,552 patients, 2,469 women (37.7%) developed postpartum depression following delivery.
- Compared with continuing antidepressants, stopping then restarting or stopping completely was associated with a higher risk of moderate-to-severe postpartum depression (adjusted relative risk [aRR] = 1.14; 95% CI, 1.05–1.24 for stopping then restarting; aRR = 1.14; 95% CI, 1.06–1.22 for stopping).
- Complete discontinuation of antidepressants during pregnancy was associated with an even higher risk of severe postpartum depression (aRR = 1.33; 95% CI, 1.09–1.62).
- Patients exhibiting at least mild depressive symptoms (PHQ-9 score ≥ 5) at their first prenatal screening (representing 50.8% of the study population) had an increased postpartum depression risk (aRR = 1.55; 95% CI, 1.45–1.65).
- Women who presented with prenatal depressive symptoms and stopped their antidepressants experienced the highest overall risk (aRR = 2.72; 95% CI, 1.94–3.82) compared to asymptomatic patients who continued their medication.
The continuation of antidepressants during pregnancy plays an important role in preventing postpartum depression among women with prior history of depressions. It can be seen that discontinuation of treatment and interruption in it increases the chance of postpartum depression especially for pregnant women who suffer from depressions. This shows that taking medications during pregnancy works as an effective measure in preventing postpartum depression.
Reference:
Ridout, K. K., Eswarappa, C., Alavi, M., Peterman, K., Harris, B., Avalos, L., & Ridout, S. J. (2026). Antidepressant Continuation in Pregnancy and Postpartum Depression Risk Across Racial and Ethnic Groups. American journal of obstetrics and gynecology, S0002-9378(26)00398-4. Advance online publication. https://doi.org/10.1016/j.ajog.2026.07.031
