Taking an Antidepressant During Pregnancy: How Babies Do in Their First Minutes, Days and Weeks

Three 2026 studies from the United States, Finland and Canada (Aref et al., Malm et al. and the NeoWISE study by Cantin et al.) on SSRI antidepressants in pregnancy, newborn adjustment after birth, breastfeeding and return visits for jaundice

Many people take a common type of antidepressant (an SSRI) in pregnancy, and three 2026 studies looked at how their babies do after birth. Exposed babies were a little more likely to need help adjusting to breathing and life outside the womb, especially after late-pregnancy use, but serious problems were not more common. These difficulties are usually brief; the advice is to give birth where a newborn team is ready and to know what to watch for at home.

Depression and anxiety are common during pregnancy, and treating them matters for both parent and baby. If you take medicine for your mental health and become pregnant, it is natural to wonder whether to keep taking it. This article explains what the new research found, what it means for your baby's first days, and what it does not mean.

Why so many families face this question

SSRIs (short for selective serotonin reuptake inhibitors) are the most common type of antidepressant. Examples include sertraline, citalopram, escitalopram and fluoxetine. They work by adjusting serotonin, one of the brain's chemical messengers. When a pregnant person takes an SSRI, the baby is exposed to it before birth too. Around the world, about 3 in every 100 pregnant people take an SSRI, and in North America the figure is closer to 5 or 6 in 100 [1]. The three studies in this article come from Tennessee in the United States [2], from the whole of Finland [3], and from the Canadian province of Ontario [4].

What doctors and families knew before

By about 20 years ago, doctors had noticed that some babies whose mothers took an SSRI late in pregnancy showed more signs of an over-stimulated serotonin system in their first few days than other babies [5]. Experts who reviewed these reports in 2005 described signs affecting the nervous system, muscles, breathing and digestion, and found that they were usually mild and had gone by 2 weeks of age [6]. One hospital study found such signs in about 30 out of every 100 exposed babies, and its authors suggested watching babies in hospital for at least 2 days [7]. In 2006, a study raised concern about a rare but serious lung condition called persistent pulmonary hypertension of the newborn, or PPHN, in which the blood vessels of the lungs do not relax properly after birth [8]. That worry led many women to stop their medicine [2]. Later, much larger studies showed that the extra risk of PPHN was small, around 3 extra cases for every 1,000 exposed babies, and partly explained by other factors [9][10]. Canadian children's doctors now describe these newborn signs as affecting about one in three exposed babies, generally mild and settling on their own, and say that breastfeeding is compatible with these medicines [11].

One big question remained. Depression itself can affect pregnancy, for example by making early (preterm) birth more likely [12]. So when babies of mothers taking SSRIs had problems, was it the medicine or the illness? And stopping is not risk-free: about half of people treated for depression stop their antidepressant in pregnancy, and some studies link stopping late to more mental-health treatment after the birth [13].

How the three new studies were done

None of the studies gave people a medicine at random; instead, each looked carefully at health records, which shows links rather than proof of cause.

The first study, by Aref and colleagues at Vanderbilt University Medical Center in Nashville, Tennessee, looked only at people who had already been taking an SSRI before pregnancy [2]. It compared 457 pregnancies in which the medicine was continued with 557 in which it was stopped before conception, using statistical methods designed to make the two groups as alike as possible. Comparing people with the same history of depression and treatment gives a fairer answer than comparing them with people who never needed treatment.

The second study, by Malm and colleagues, used Finland's national health records covering about 1.27 million births [3]. It compared 19,020 pregnancies in which the mother bought an SSRI at least twice with 19,625 pregnancies of mothers who had depression but took no antidepressant. It also compared brothers and sisters born to the same mother, and looked at fathers who took SSRIs, as a check on whether family background explained the findings.

The third study is called NeoWISE, short for Neonates With In-utero SSRI Exposure. It followed babies born in Ontario hospitals between 2012 and 2020 whose mothers took an SSRI and had public drug coverage, and it compared 3,321 babies who were only breastfed in hospital with 1,758 who were only formula-fed [4].

What happened in the first minutes after birth

The Apgar score is a quick 0 to 10 score of how well a newborn is doing, given at 1 minute and 5 minutes after birth. In the Tennessee study, babies whose mothers continued their SSRI scored on average a little under half a point lower at 1 minute and about a quarter of a point lower at 5 minutes [2]. They were also more likely to have meconium, the baby's first stool, in the fluid around them at birth: about 21 in every 100 babies compared with about 13 in every 100. The researchers were cautious about the meconium finding because it did not hold up in all of their checks.

The Finnish study found a similar pattern. About 10 in every 100 babies exposed to SSRIs had an Apgar score below 7 at 1 minute, compared with about 6 in every 100 babies of mothers with untreated depression, and breathing problems were recorded in about 9 in 100 compared with about 6 in 100 [3]. The difference was greatest when the medicine was taken in the last three months of pregnancy. Importantly, the same pattern appeared when brothers and sisters were compared, and it did not appear when only the father took an SSRI. That makes it likely that the medicine itself, not only the depression or family circumstances, explains this short-lived difficulty in adjusting.

What about serious problems?

This is where the news is reassuring. In Tennessee, PPHN affected 6 babies out of 457 whose mothers continued their medicine and 3 out of 557 whose mothers stopped, too few to tell whether there was any real difference [2]. In Finland, PPHN was not more common in babies exposed to SSRIs than in babies of mothers with untreated depression [3]. Birth defects were not more common either: in Tennessee, about 7 in 100 babies had one in both groups.

Admission to the neonatal intensive care unit (NICU), the hospital ward for newborns who need extra care, was 13 in 100 for babies whose mothers continued the medicine and 11 in 100 for those whose mothers stopped, a difference that could have happened by chance [2]. The much bigger Finnish study did find slightly more babies being watched in a newborn unit, about 18 in 100 compared with about 14 in 100 [3]. Being watched more closely for a while is not the same as being seriously ill.

The Finnish study also found that very early birth was less common in mothers taking SSRIs than in mothers with untreated depression, while untreated depression was itself linked to more very early births [3]. This finding was not consistent across all comparisons, but it is a reminder that leaving depression untreated can also affect the baby.

Breastfeeding, jaundice and going home

The Ontario study looked at the days and weeks after birth. Breastfed babies were less likely to stay in hospital for 3 days or more: about 12 in 100 compared with about 16 in 100 formula-fed babies [4]. But in the first month, breastfed babies were a little more likely to return to an emergency department (about 4 in 100 compared with 3 in 100) or to be readmitted to hospital (about 4 in 100 compared with 2 in 100). The main reason was jaundice, a yellowing of the skin and eyes caused by a substance called bilirubin, and a common reason for readmission among newborns in general [4]. Return visits for withdrawal-type symptoms were very rare in both groups, and an earlier report from the same study found that feeding method did not change how often babies were diagnosed with these symptoms [14].

This does not mean breastfeeding is a bad choice. It means that breastfed babies who go home early need parents to know how to tell whether feeding is going well and how to spot jaundice.

What this means for you and your baby

If you take an SSRI, the best step is to talk it through with your doctor or midwife, ideally before or early in pregnancy, rather than deciding alone. The Tennessee researchers point out that a slightly lower Apgar score with no other complications does not suggest lasting harm, and that it must be weighed against the possible effects of stopping treatment on the mental health of both parent and child [2]. Canadian guidance for perinatal mental health covers both medicines and other forms of treatment [15].

The researchers offered three practical messages. Plan to give birth in a hospital that can give newborn breathing support if needed [2]. Expect your baby to be watched closely after birth [3]. Before going home, ask for guidance on feeding, on signs of jaundice and on when to seek help [4]. You can read more about how maternal depression itself can affect babies in our article on perinatal depression and infant risk.

What researchers are working on next

Researchers want to learn whether the dose or the specific medicine matters, which babies need longer observation, and whether the extra jaundice visits seen in breastfed babies are any higher than in breastfed babies who were never exposed. They also hope to follow children over time to confirm that small differences at birth do not matter later.

The bottom line

Continuing an SSRI during pregnancy, especially late in pregnancy, is linked to a slightly higher chance that a baby will need some extra help adjusting in the first minutes and days. These difficulties are usually brief, and serious problems were not more common in these studies. With a prepared birth team and good guidance before going home, most families can expect their baby to settle well.

References

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  2. Aref L, Hughey JJ, Shirazi S, Sucre JMS, Bastarache L. Neonatal Outcomes Following Selective Serotonin Reuptake Inhibitor Use During Pregnancy. JAMA Netw Open. 2026;9(7):e2622790. doi:10.1001/jamanetworkopen.2026.22790 ↩
  3. Malm H, Brown AS, Cheslack-Postava K, et al. Selective serotonin reuptake inhibitor use during pregnancy and maternal depression-a nationwide birth cohort study on risks to the mother and the newborn. Am J Obstet Gynecol MFM. 2026;8(4):101910. doi:10.1016/j.ajogmf.2026.101910 ↩
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