Workshop Group 1 Question 2 by Kingston https://padlet.com/kingrajiah/1n1ixjq9jai0 Pregnancy and Breast feeding en-us 2015-09-07 08:44:09 UTC 2016-09-07 01:40:12 UTC hello@padlet.com A 42-year old mother-to-be (first pregnancy; 4 weeks pregnant) has been taking sertraline for six months, for depression. Her depression has only recently got better & she does not wish to stop her medication. Comment. kingrajiah https://padlet.com/kingrajiah/1n1ixjq9jai0/wish/68830771 2015-09-07 09:01:58 UTC https://padlet.com/kingrajiah/1n1ixjq9jai0/wish/68830771 Question  https://padlet.com/kingrajiah/1n1ixjq9jai0/wish/121976850 2016-09-07 00:50:45 UTC https://padlet.com/kingrajiah/1n1ixjq9jai0/wish/121976850 ANSWER https://padlet.com/kingrajiah/1n1ixjq9jai0/wish/121977324 The use of sertraline (a SSRI) should be continued
Pregnancy category C - Use Is indicated if benefits outweigh the risks

Use of antidepressants in pregnancy - Evidence on safety
Current available data reveal that with one exception (paroxetine), there does not appear to be an increased risk of major malformations with exposure to antidepressants in utero.

SSRIs are generally preferred by many practitioners during pregnancy since they are well-tolerated. Of the SSRI medications, both fluoxetine and sertraline have more data regarding safety than the newer SSRIs, eg escitalopram.

Avoiding antidepressant use during pregnancy or lactation is often not an option. Studies have shown that terminating antidepressant treatment in pregnancy in women with a previous history of depression leads to a relapse of symptoms in as much as 60-70% of women.

Antenatal depression has been associated with low maternal weight gain, increased rates of preterm birth, low birth weight, increased rates of cigarette, alcohol and other substance use.

Prenatal exposure to maternal stress also have consequences for the development of infant temperament. Children affected with maternal depression have higher cortisol levels than infant mothers who were not depressed - Maternal treatment of depression during pregnancy appears to help normalize infant cortisol levels.

(Taken from "Antidepressant Use During Pregnancy: Current Controversies and Treatment Strategies" from doi: 10.1097/GRF.0b013e3181b52e20)

Extra care has to be taken when SSRIs are used during the third trimester
Some research associates use of sertraline with a rare but serious newborn lung problem (persistent pulmonary hypertension of the newborn) when taken during the last half of pregnancy.
From: http://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/antidepressants/art-20046420]]> 2016-09-07 00:54:49 UTC https://padlet.com/kingrajiah/1n1ixjq9jai0/wish/121977324