Sertraline is a popular medication in the category of selective serotonin reuptake inhibitors (SSRIs) that is mainly prescribed for depression, anxiety, obsessive-compulsive disorder (OCD), and post-traumatic stress disorder (PTSD). However, in pregnancy, the administration of any medication during pregnancy brings into question the risk to the mother and the developing child. If you are pregnant or trying to become pregnant and are taking sertraline or if you intend to take it as a form of treatment, then you must know the benefits and also the risks.

What is Sertraline?

Sertraline accomplishes this by raising the level of serotonin, a chemical messenger that contributes to mood, anxiety, and other brain functions. Sertraline prevents the reuptake of serotonin, keeping it in the brain longer to produce improved mood and symptom relief of mental illness.

Sertraline and Pregnancy: What Research Shows

The connection between sertraline use during pregnancy and risk is currently under investigation. Whether SSRIs, such as sertraline, influence pregnancy, fetal development, and long-term child health has been studied. Here is a summary of the overall findings:

First Trimester Risks

In the first trimester, when the organs of the baby are developing, there are fears that drugs such as sertraline may cause congenital disabilities. Most studies, however, conclude that the risk of significant congenital disabilities with sertraline use during early pregnancy is low. An extensive survey of the National Birth Defects Prevention Study did not find an increased risk of substantial congenital disabilities in women who used sertraline during the first trimester.

Chances of Miscarriage

There have been some study hints of a slight risk increase of miscarriage with the administration of SSRIs, including sertraline, during early pregnancy. However, the risk is low overall, and further evidence is required to draw firm conclusions. It must be noted that depression or anxiety that goes untreated in pregnancy also has the potential to cause complications, and, therefore, the decision to withdraw or continue drugs must be weighed suitably.

Preterm Delivery and Low Birth Weight

Some research indicates that SSRIs like sertraline could lead to low birth weight or preterm delivery by a small proportion. However, the evidence is not conclusive, and most of these dangers could be due to the condition being treated and not the drug.

Neonatal Adaptation Syndrome

One of the most frequent risks of sertraline exposure during pregnancy that has been discussed is Neonatal Adaptation Syndrome (NAS), where the baby is harmed by some drugs taken during pregnancy. NAS symptoms are typical symptoms like breathing problems, irritability, feeding problems, and body temperature problems. They are typically mild and disappear within a few days of giving birth, but are upsetting for both parents and infants.

Persistent Pulmonary Hypertension of the Newborn (PPHN)

A potential connection has been challenged between SSRIs, such as sertraline, and Newborn Persistent Pulmonary Hypertension (PPHN), a severe and unusual condition in which a newborn’s circulatory system fails to adapt following birth, leading to breathing trouble. Several studies indicate that late pregnancy exposure to SSRIs may pose a risk for PPHN, but this is not yet established.

Long-Term Impact on Child Development

Evidence on the long-term developmental impact of sertraline exposure in pregnancy is still limited. There have been some reports, however, that children exposed to SSRIs in pregnancy might be at a small, but perhaps slightly increased, risk of delayed development, e.g., of language or motor skills. This risk appears to be very small but is an area where research is needed.

Balancing the Risks: What Do You Do?

If you are pregnant or could become pregnant, be sure to consider the benefits and risks of using sertraline. Some things you should know are listed below:

Consult Your Healthcare Provider

Do not alter your medication schedule in any way unless your obstetrician and psychiatrist instruct you. They can discuss with you the advantages and disadvantages of staying on sertraline during pregnancy and whether treatment is necessary in addition. If you are treated with sertraline for depression or anxiety, the benefits of staying on treatment for these illnesses during pregnancy far outweigh the disadvantages if the disease is severe.

Consider Non-Medication Therapies

For some women, therapy and lifestyle change are good alternatives to medications like sertraline. Cognitive-behavioral therapy (CBT), mindfulness exercises, or support groups may be beneficial tools for handling mental health during pregnancy. Speak with your medical professional to learn what would suit your mental well-being.

Be Vigilant of Side Effects

If you persist in taking sertraline while pregnant, your doctor will need to closely follow up and monitor you. Make sure to report any new or worsening symptoms, both emotional and physical, to your doctor. If caught early, complications can be avoided, and you and your baby can remain healthy.

Postpartum Considerations

Following birth, the question of whether or not sertraline can affect breastfeeding should be addressed. Sertraline does pass into breast milk but is not usually harmful to women who are lactating. Every circumstance is unique, however, and your physician can provide guidance regarding substitutes or monitoring techniques if complications arise.

Pharmacogenetic (PGx) Role in the Control of Sertraline Consumption During Pregnancy

Pharmacogenetic (PGx) testing is a resource that can help make the administration of sertraline in pregnancy more personalized based on one’s genetic makeup and response to the drug. PGx testing can predict how well a pregnant woman is going to metabolize sertraline, and it is key because some variations in genes could lead to an under-responsive or overactive effect on the drug. Such genetic determinants inform clinicians how to titrate dosing, more accurately reducing fetal and maternal side effects. PGx testing can also identify women who will need alternative medication with improved safety during pregnancy, enabling the best management of both fetal development and maternal mental health.

Conclusion

While sertraline is safe during pregnancy under medical guidance, it is far from riskless. The risk of the following complications will need to be balanced against the value of treating mental illness with pregnancy: neonatal adaptation syndrome, preterm birth, and PPHN. Each pregnancy is unique, and therefore, the choice of continuing or stopping sertraline would be made together with your doctor, considering your mental status, the degree of your illness, and other individual considerations.

If you are pregnant, it is advisable to have an open and continuous conversation with your healthcare provider to ensure the optimal outcome for you and the baby. Also, learn https://rphlabs.com/how-long-does-zoloft-stay-in-your-system-know-in-depth/

References

https://www.ncbi.nlm.nih.gov/books/NBK582954/
https://www.ajog.org/article/S0002-9378(15)00090-3/fulltext
https://www.drugs.com/pregnancy/sertraline.html

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