A recent study investigated the rela- tionship between the use of SSRIs prior to or during pregnancy and the development of gestational hypertension and preeclamp- sia. The study included a total of 5,731 women, of whom 199 took SSRIs two months prior to pregnancy and possibly during pregnancy. Nurses conducted tele- phone interviews with all participants within six months of delivery, collecting data on several relevant variables, such as smoking, alcohol consumption, dietary intake, dia- betes, pre-pregnancy weight, and infertility treatment. Of women who took SSRIs during the study period, 19% developed gestational hypertension, compared to 9% of women who did not take SSRIs. The women at highest risk for gestational hypertension and preeclampsia were those who continued taking SSRIs after the end of the first trimester; women who continued SSRI treatment were 4.86 times as likely to report developing preeclampsia as women who did not take SSRIs during the study period (Toh S et al., Am J Psychiatry 2009;166:320-328).

TCPR’s Take: An accompanying edito- rial pointed to several limitations in the study (Yonkers KA, Am J Psychiatry 2009; 166:268-270). The researchers did not examine the medical records of participants; thus, it is impossible to know if participant’s recollections of preeclampsia or gestational hypertension were fully accurate. Child outcomes were not assessed in the study. Perhaps most important, the extent to which increased risk is due to SSRI exposure or due to underlying depression and/or anxiety is unknown. For more on the complicated relationship between antide- pressants and pregnancy, see the February 2009 issue of TCPR.