Zoloft and Pregnancy

Zoloft (sertraline hydrochloride) is a popular prescription medication that was introduced to the public in 1991 by Pfizer to treat depression. The drug is a selective serotonin reuptake inhibitor (SSRI), a class of antidepressants considered to be the newest and best standard of care for most patients. SSRIs are designed to boost the level of serotonin in the brain because researchers believe that an inadequate amount of the substance triggers depression.

Two decades after Zoloft came on the market, scientists and physicians are discovering that SSRIs cause a host of serious and lasting side effects and birth defects. Most SSRIs, including Zoloft, have not been deemed safe for pregnant women to take because such medications easily cross the placenta to the baby.

The U.S. Food and Drug Administration (FDA) assigns each drug a safety grade for use during pregnancy. Zoloft, like its fellow SSRIs, has been labeled a C. That grade means that high levels of the drug have been found to harm research animals, but its effects are unproven on human fetuses. And yet, doctors allow their patients to risk their babies' health and their own by taking Zoloft.

1st Trimester Side Effects

The first trimester of a baby's life is a critical time for development, and outside influences, such as the use of Zoloft, can disrupt normal growth of vital organs. Two serious defects that occur early in utero -- atrial septal defects (ASD) and ventricular septal defects (VSD) -- essentially are holes in the chambers of the heart.

These malformations were linked in 2009 to the use of SSRIs during pregnancy, according to a British Journal of Medicine study. The findings state that if a woman takes an SSRI during pregnancy, her baby is four times as likely to be born with one of these heart defects.

ASD and VSD affect the circulation of blood through the heart, meaning it has to pump harder to achieve the necessary flow pattern. In some cases, if the heart is not repaired surgically, the extra workload ultimately can lead to heart failure.

3rd Trimester Side Effects

When an SSRI, such as Zoloft, is taken during the third trimester, it can damage a baby's heart in other ways, studies have found. Persistent pulmonary hypertension of the newborn (PPHN) affects the heart and lungs in utero, but doctors and caregivers are unlikely to know about the baby's complications until after he or she is born.

PPHN becomes apparent when a baby cannot breathe on his or her own outside the mother's body. It is characterized by quick breathing and breathlessness, rapid heart rate, lethargy, sweating and a bluish hue to the skin. Such serious symptoms may require intensive care and a mechanical ventilator.

In 2006, the FDA issued a Public Health Advisory warning women that taking an SSRI like Zoloft during the second half of pregnancy increases the risk of PPHN in her baby. Furthermore, the agency reports that PPHN is fatal in about 10 percent of cases.