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Arch Pediatr Adolesc Med. 2004;158:307-308.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Depression may affect up to 20% of pregnant women,^1-2 which translates into 80 000 women in the United States per year. There is increasing evidence to suggest adverse effects of untreated depression during pregnancy, including increased risk of miscarriage, prematurity, growth retardation, and low Apgar scores.^3-9 Importantly, untreated or even undertreated depression can cause increased maternal risk of poor prenatal care, suicidal ideation, suicide attempts, and postpartum depression.^{3, 10}

Quite commonly, women report that a physician advised them to discontinue taking antidepressants "cold turkey" once pregnancy was diagnosed because of fears of teratogenicity.¹¹ This can create serious morbidity, including need for hospitalization and suicidal ideation. Some women may substitute drugs of abuse and alcohol for antidepressants.¹¹ Much more prevalent but just as important is suboptimal treatment of depression during pregnancy. Many women receive very small doses of antidepressants, which do not allow optimal effects.¹² Moreover, increased body weight and the enhanced clearance . . . [Full Text of this Article]

Gideon Koren, MD, FABMT, FRCPC
Division of Clinical Pharmacology and Toxicology
The Hospital for Sick Children
555 University Ave
Toronto, Ontario
Canada M5G1X8
(e-mail: gkoren@sickkids.ca)

gkoren@sickkids.ca

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