Safety of Sertraline During Pregnancy

Benefits vs. Risks Assessment

Depression during pregnancy is associated with premature birth and decreased initiation of breastfeeding, making treatment important for maternal and fetal wellbeing 1, 2
Sertraline is one of the most commonly prescribed antidepressants during pregnancy and breastfeeding due to its favorable safety profile 2

Some studies suggest a possible association between SSRI use during pregnancy and persistent pulmonary hypertension of the newborn (PPHN), though evidence is conflicting 1, 2
A meta-analysis indicated a number needed to harm of 286-351 for PPHN with late pregnancy SSRI exposure 1, 2
A large population-based cohort study found no link between first-trimester antidepressant use and cardiac malformations 1, 2

Use the lowest effective dose of sertraline during pregnancy 3
Monitor for symptoms of depression throughout pregnancy, as untreated depression poses significant risks 1, 2
For women already taking sertraline who become pregnant, continuation of treatment is generally recommended if clinically indicated 3
Arrange for early follow-up after hospital discharge for infants exposed to sertraline in the third trimester to monitor for neonatal adaptation syndrome 3

Sertraline transfers in low concentrations into breast milk and is considered one of the preferred antidepressants during breastfeeding 1, 2
Paroxetine and sertraline are the most commonly prescribed antidepressants during breastfeeding due to their favorable safety profiles 1, 2

Assess severity of depression and necessity of medication treatment 3
If treatment is indicated, sertraline is a preferred option during pregnancy 1, 2
Use the lowest effective dose and monitor maternal mental health closely 3
Continue sertraline during breastfeeding if clinically indicated 1, 2