美国国家公共电台 NPR Xanax Or Zoloft For Moms-To-Be: A New Study Assesses Safety

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MARY LOUISE KELLY, HOST:

Lots of people take prescription¹ medications such as Xanax or Zoloft for anxiety and depression, but is it OK to take them while pregnant? NPR's Allison Aubrey reports on new findings that offer some answers.

ALLISON AUBREY, BYLINE²: Earlier this year, when Emily Chodos was about 25 weeks into her pregnancy³, she woke up one night feeling horrible.

EMILY CHODOS: My hands were shaking and tremoring. My heart would be racing⁴. I'd be gasping⁵ for air and pacing the house.

AUBREY: This went on for several days.

CHODOS: I'd never felt so out of control of my body.

AUBREY: It got to the point where she couldn't fall asleep, so she reached out to her obstetrician's office.

CHODOS: I ended up paging her at about 4 a.m. one night when I was so panicked, and one of the midwives immediately said, it sounds like you're having a panic attack.

AUBREY: The midwife advised her to take an anti-anxiety medication and come in the next day for a consultation⁶.

CHODOS: It was Xanax, and I was afraid to take it, as a pregnant woman.

AUBREY: Chodos, who is trained as a nurse, knew there were some concerns about this class of medication. Scientists haven't ruled out the risk of adverse⁷ effects for pregnant women.

CHODOS: I actually felt very trapped - that there was probably no safe medication, and I would just have to suffer and feel awful.

AUBREY: But on her doctor's suggestion, she went to see a psychiatrist⁸ - Kimberly Yonkers at Yale University. Yonkers has been studying the effects of these medications in pregnant women - particularly, women with anxiety and panic disorders⁹. And she understands why women are torn about the drugs.

KIMBERLY YONKERS: It's kind of a tricky¹⁰ balance, right? People have this illness that they didn't ask for and they don't want, and they're really suffering.

AUBREY: The medications can help, but women worry about the potential risks to their baby's health. To understand the risks better, Yonkers and her collaborators studied about 2,600 women during pregnancy and after childbirth. For women taking these drugs, Yonkers did find some risks - for instance, an increase in C-section deliveries. Their babies were also a little more likely to need oxygen or some other ventilatory support after birth.

YONKERS: And we also found that the duration of pregnancy was shortened by, on average, 3.6 days - so quite modest.

AUBREY: Women on antidepressants also had their pregnancies¹¹ shortened but by less than two days. And their babies were a little more likely to require oxygen or other respiratory support just after birth. So while these medications are not risk-free, Yonkers says...

YONKERS: It should be reassuring¹² to most people that we are not seeing a huge magnitude of an effect here.

AUBREY: The study, which is published in the journal JAMA Psychiatry¹³, also found that the anxiety disorders themselves don't pose risks to babies' health. But Yonkers says the results suggest that women who need treatment for these disorders don't have to stop taking these medications during pregnancy.

David Garry is a maternal¹⁴ fetal medicine specialist at Stony¹⁵ Brook¹⁶ University. He agrees, and he says every woman should talk to her doctor and come up with a treatment plan.

DAVID GARRY: I think you have to look at what medication it is. Then decide, can she be on a lower dose, can she come off the medication, or should she remain right where she is?

AUBREY: Garry says that's the best approach. Allison Aubrey, NPR News.