Posted by Claudia Grazioso on April 11, 2011
To people who battle depression, panic disorder or even Post Traumatic Stress Disorder, drugs like Zoloft (sertraline) can seem like a life raft, and one they are reluctant to get off. This can present some problems for women who become pregnant while using Zoloft. Is it safe for the baby or not? Presently, the American College of Obstetricians and Gynecologists recommends that doctors take it on a case-by-case basis. If you are an expectant mother using Zoloft, or considering Zoloft, there are some things you should know so you can make an informed decision based on your needs and your tolerance for risk.
Some studies have linked Zoloft to an increase in problems like low birth weight, and premature birth. These problems were exacerbated when the mom drank, smoked or was on additional medications to treat mental illness. Also, some babies were born with possible withdrawal symptoms: tremors, convulsions, increased crying. In general, these problems were short-lived, but it is important to note that frequently sertraline was found in fetal blood in significant amounts. To avoid withdrawal symptoms, some doctors recommend tapering off the dose before the mother’s due date.
Like many other SSRIs, Zoloft is a Category C drug. That means that in clinical studies on animals, it was found to cause birth defects. Human babies who have been exposed to Zoloft in the first trimester are believed to be at increased risk for omphalocele, a defect in the abdominal wall that causes organs to develop outside of the abdominal cavity. They also seem to be at increased risk for anal atresion, in which the baby’s anal opening is missing or misplaced; and ventricular and atrial defects, defects in the walls of the heart.
One of the most worrisome birth defects associated with SSRIs is Persistent Pulmonary Hypertension of the Newborn, a cardiac defect that can result in respiratory problems and low blood oxygen levels and can be serious. Studies show that women who take SSRI drugs after the 20th week of their pregnancy are at an increased risk for having a baby with PPHN. Though it is serious, PPHN is rare. Just because you are taking Zoloft during your pregnancy does not mean you are going to have a child with cardiac birth defects, or any defect. The instance of these birth defects is still relatively low, but exposure to SSRI drugs does seem to raise the risk. To lower the risk of a birth defect like PPHN, your doctor might recommend weaning you off Zoloft as you approach your third trimester, either lowering your dose, or moving off of it completely.
There are so many things we give up when we’re pregnant for the well-being of our children. Arrivaderci latte, au revoir Chablis, sayonara Sushi. But going off a medication is different and untreated depression can have its own consequences. If you take Zoloft and are considering stopping for the duration of your pregnancy, talk to your doctor about the benefits and risks. He or she will help you to make an informed decision.