New research indicates that using selective serotonin reuptake inhibitor (SSRI) antidepressants during pregnancy may help reduce the risk of preterm birth and low birth weight. An extensive population-based study involving over 1.2 million births suggests these medications offer a protective effect, particularly against very preterm birth. This finding brings a new perspective to the complex decision-making process for expectant mothers and their doctors regarding mental health treatment.^[1][2] ### Untreated Depression's Clear Dangers Depression is a common condition, affecting about 10% to 15% of pregnant women.^[3][4] Untreated maternal depression poses significant risks for both the mother and the baby. Babies born to mothers with untreated depression face an increased risk of premature birth, low birth weight, and restricted growth in the womb.^{[5][6][7][8][9][10][11][4]} The negative consequences extend beyond physical health. Untreated depression can lead to difficulties in mother-infant bonding and can affect a child's emotional, social, and cognitive development.^{[8][11][4][12]} For the mother, untreated depression can worsen symptoms, potentially leading to postpartum depression and an increased risk of suicide.^{[7][10][13][14][15]} It can also increase the likelihood of pregnancy complications like preeclampsia.^{[7][10][14][16]} ### Antidepressants: A Nuanced Picture Emerges Recent studies are shedding new light on the role of antidepressants. A February 2026 study, which analyzed over 1.2 million births, found that SSRI use during pregnancy was associated with a lower risk of very preterm birth and low birth weight.^[1][2] This research carefully distinguished the effects of the medication from the underlying maternal depression by using sibling comparisons and multiple control groups.^[1][2] Similarly, an April 2024 study by the March of Dimes Prematurity Research Center at the University of California, San Francisco (UCSF), found that taking antidepressants during pregnancy did not increase the risk of preterm birth.^[17] In fact, this study showed that the risk of preterm birth increased by 10% for women with a history of depression who did not take antidepressants during pregnancy, compared to those without a history of depression.^[17] The authors concluded that the effect of SSRIs on preterm birth risk was benign.^[17] These findings align with an earlier meta-analysis from August 2015, which indicated that pregnant women taking SSRIs had a 16% lower risk of preterm birth and a 48% lower risk of very preterm birth, compared to depressed women who did not use SSRIs.^[18][19] This suggests that treating depression with SSRIs might offer a protective effect against early delivery.^[18][19] However, it is important to note that some older research has presented different conclusions. A 2015 meta-analysis of eight studies, for instance, found a significantly higher risk of preterm birth in women who received SSRIs during pregnancy, even when compared to depressed women not on SSRIs.^[3] Other studies from 2014, 2015, and 2020 also linked SSRI use, particularly in the third trimester, to increased rates of preterm birth.^{[3][20][21][22][23]} These conflicting results highlight the ongoing nature of scientific research and the importance of robust study designs that account for the severity of underlying depression. ### Other Considerations and Neonatal Effects While newer research points to potential benefits regarding preterm birth, antidepressant use during pregnancy comes with other important considerations. Studies have consistently shown an increased risk of gestational diabetes for pregnant women taking SSRIs.^[1][5][2] Newborns exposed to SSRIs in the womb may also experience temporary "neonatal adaptation syndrome" symptoms. These can include lower Apgar scores, breathing difficulties, jitteriness, irritability, and a need for neonatal care.^{[1][18][6][2][24][19][11]} Doctors believe these are often withdrawal-like symptoms that usually resolve on their own.^[24] Importantly, most studies show no increased risk of major congenital malformations with SSRI use, though paroxetine (Paxil) might slightly raise the risk of heart defects if used in the first trimester.^{[1][5][18][2][7][24]} Some research also suggests SSRI use may lower the risk of requiring a C-section delivery.^{[1][18][2][19]} ### Balancing Risks and Benefits for Expectant Mothers The decision to use antidepressants during pregnancy requires a careful balance of risks and benefits, made in close consultation with healthcare providers. "Our results emphasize the significance of individualized treatment decisions during pregnancy," said Docent Heli Malm, lead author of the February 2026 study from the University of Turku.^[2] Malm added that "the treatment of depression is important, and the use of SSRIs seems to protect against the risk of preterm birth associated with depression. At the same time, however, it is necessary to closely monitor both the progress of the pregnancy and the health of the newborn."^[2] Medical professionals generally agree that the risks of untreated mental illness during pregnancy often outweigh the potential risks of SSRIs.^[14] Abruptly stopping antidepressant medication during pregnancy can lead to a higher risk of mental health emergencies, including psychosis or substance overdose.^[14] This underscores the importance of not discontinuing treatment without medical guidance. Specialized medical supervision by a multidisciplinary team, including obstetricians, psychiatrists, and psychologists, is essential to address the individual needs of pregnant women.^[16] The goal is to choose treatments that effectively manage depression while minimizing side effects for both mother and child.^[16] Ultimately, for many pregnant women, the benefits of treating depression with antidepressants, including the potential to reduce preterm birth risks, are increasingly recognized as crucial for both maternal and infant well-being.

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