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Antidepressants in pregnancy
Up to 8% of pregnant women are prescribed antidepressants, and there is understandable concern about whether these drugs have any adverse neurodevelopmental effects on the child. Some earlier cohort studies have suggested that there might be, but it is difficult to separate the effects of the drugs from the depression itself. A study from Australia is therefore reassuring (Acta Paeds on-line July 2013): they compared 35 infants exposed to antidepressants during the 2nd and 3rd trimesters with 23 unmedicated controls. The medications were mostly selective serotonin reuptake inhibitors (SSRIs) and most were taken for the whole pregnancy. The children were all assessed using the Bayley scales (BSID-III) by blinded assessors at 18 months. There were no significant differences in any of the domains. One note of caution: the study was part-sponsored by pharmaceutical company Pfizer. As paediatricians we frequently see the results of untreated maternal depression on the child as neglect and abuse: this, and some other studies, should reassure pregnant women that it is best to continue to take prescribed antidepressants.
Antifungals in pregnancy
Some case reports have highlighted a possible association between long-term use of antifungal drugs such as Fluconazole, and specific birth defects, leading the Food and Drugs Administration …