Posted by Larry Hoover on October 28, 2004, at 14:58:21
In reply to Re: HELP - I'm pregnant-recent article, posted by Starlight on October 28, 2004, at 13:16:10
> Use of these drugs are linked to congenital malformations and I for one, don't want to be the rat that gets experimented on.
The fact is, neither antidepressants nor benzodiazepines are linked to congenital malformations in cohort studies. In case control studies, there is a very weak link, but the cohort data is more reliable. If you take the cohort meta-analysis (link below) at face value, there is a reduced risk of malformations, but it's more likely that there is no difference between exposed and non-exposed pregnancies.
A cohort study is a look at a large group of cases, where differences within the group (such as exposure to benzodiazepines) are examined to see if there are different outcomes. In this example, benzo-exposed pregnancies had a malformation risk of 0.9 (less likely) when compared to unexposed pregnancies in the same cohort.
In a case-control study, you look at outcomes (positive cases vs. negative cases) and look for factors that might have led to those different outcomes. The problem with this type of study is that it does not take into account any differences in baseline health characteristics. For example, the question "Does anxiety itself lead to birth defects?", is not answered. Benzo use might be correlated to birth defects because both are themselves correlated with anxiety.
Here's a link to a full-text analysis of the issue. Dr. Koren heads the Hospital for Sick Children Motherisk Program, which assesses and monitors the effects of drugs and toxicants on pregnancy outcomes.
http://bmj.bmjjournals.com/cgi/content/full/317/7162/839
Here, also, is an article Koren wrote about the risks of treated and untreated depression during pregnancy, found on the Society of Obstetricians and Gynecologists of Canada website:
http://www.sogc.org/sogcnet/sogc_docs/press/pdfs/Discontinuation_Syndrome_Following.pdf
I will not argue that the issue is settled. It is not. If anxiety or depression could be of significant effect during pregnancy, I think that serious consideration should be given to treatment. Untreated anxiety during pregnancy can have permanent adverse effects on a child's development (references available).
Lar
My Pdoc, who is female said I had to come off of everything and I agree. From what I understand, once you get past the first trimester, the hormones that your body is releasing has a positive impact on moods and the worst part is the potential for post partum depression, although I would think that breast feeding would also have a good impact hormonally.
> starlight
poster:Larry Hoover
thread:407900
URL: http://www.dr-bob.org/babble/20041024/msgs/408431.html