Therapies used in pregnant women who present Major Depressive Disorder and its postpartum implications




Major Depressive Disorder; Postpartum Depression; Maternal Responsiveness; Selective Serotonin Reuptake Inhibitors; Nursing.


Objective: Debate on the therapies most used in pregnant women with MDD and analyze the postpartum implications, in addition to the risks and benefits of the drugs of choice. Methodology: Integrative literature review, using articles from the academic platforms SciELO, PuBMED, MEDLINE and Science Direct, considering an interval between 2016-2021, that addressed the subject of pharmacological therapy with Selective Serotonin Reuptake Inhibitors (SSRIs) and/or Serotonin Norepinephrine Reuptake Inhibitors (SNRIs) in the gestational period or non-adherence to treatment, with a finding of 12 articles that met the inclusion and exclusion criteria. Results: Most studies support the effectiveness of treatment with SSRIs and/or SNRIs in pregnant women, but there is difficulty in developing a plan with the lowest possible risk, because the drugs with the best results also present a certain degree of risk. These same studies, as well as others, highlight the teratogenic effects and some other findings during treatments with SSRIs and/or SNRIs and, in case of non-treatment, the effects of depression throughout pregnancy. Some of the findings indicate adherence to co-treatment using non-pharmacological therapies, such as psychotherapy (recommended by guidelines as the ideal initial treatment in mild to moderate cases), associated with pharmacological therapy. Conclusions: It can be concluded that there are studies on the benefits and harms of the use of antidepressants during pregnancy, in such a way that it is difficult to define the best strategy, it being up to professionals to define cost-benefit according to each patient and situation.


World Health Organization (WHO) (2020) Depression.

Albert, P. R. (2015). Why Is Depression More Prevalent in Women?. Journal of Psychiatry & Neuroscience, 40 (4), 219–221.

Gordon, J. L., & Girdler, S. S. (2014). Hormone replacement therapy in the treatment of perimenopausal depression. Curr Psychiatry Rep., 16 (12), 517.

American Psychiatric Association (2014). Manual diagnóstico e estatístico de transtornos mentais V (DSM-V). Porto Alegre: Artmed

Carvalho, L. A. G. et al. (2020). Tratamento farmacológico da depressão em gestantes: uma revisão da literatura. Brazilian Journal of Health Review, Curitiba, 3(4), 10891-10900.

Klieman, A., Boing, E., & Crepaldi, M. A. (2017). Fatores de risco para ansiedade e depressão na gestação: revisão sistemática de artigos empíricos. Mudanças- Psicologia da Saúde, 25(2), 69-76

Silva, B. A. B. et al. (2020). Depressão em gestantes atendidas na atenção primária à saúde. Cogitare enferm. [Internet]; 25.

Krob, A. D. et al. (2017). Depressão na gestação e no pós-parto e a responsividade materna nesse contexto. Rev. Psicol. Saúde, Campo Grande, 9(3), 3-16.

Fonseca, A. D., & Canavarro, M. C. (2017). Depressão Pós-Parto. In: PROPSICO: Programa de atualização em Psicologia Clínica e da Saúde Ciclo 1. 111-164. Porto Alegre: Artmed Panamericana Editora.

Zhao, X., Liu, Q., Cao, S., Pang, J., Zhang, H., Feng, T. et al. (2017). A meta-analysis of Selective Serotonin Reuptake Inhibitors (SSRIs) use during prenatal depression and risk of low birth weight and small for gestational age. J. Affective Disorders, 230, 1-124.

Hutchison, S. M., Masse, L. C., Pawluski, J. L., & Oberlaner, T. F. (2018). Perinatal Selective Serotonin Reuptake Inhibitor (SSRI) Effects on Body Weight at Birth and Beyond: a review of animal and human studies. J. Reproductive Toxicology.

Guan, H-B., Wei, Y., Wang, L-L., Qiao, C., & Liu, C-X. (2018). Prenatal Selective Serotonin Reuptake Inhibitor Use and Associated Risk for Gestacional Hypertension and Preeclampsia: a meta-analysis of cohort studies. J. Women’s Health.<10.1089/jwh.2017.6642

Gao, S-Y., Wu, Q-J., Sun, C., Zhang, T-N., Shen, Z-Q., Liu, C-X. et al. (2018). Selective serotonin reuptake inhibitor use during early pregnancy and congenital malformations: a systematic review and meta-analysis of cohort studies of more than 9 milion births. BMC Medicine, 16(205).

Singal, D., Chateau, D., Struck, S., Lee, J. B., Dahl, M., Derksen, S. et al. (2020). In Utero Antidepressants and Neurodevelopmental Outcomes in Kindergarteners. PEDIATRICS, 145(5).

Masarwa, R., Bar-Oz, B., Gorelik, E., Reif, S., Perlman, A., & Matok, I. (2019). Prenatal exposure to selective serotonin reuptake inhibitors and serotonin norepinephrine reuptake inhibitors and risk for persistent pulmonary hypertension of the newborn: a systematic review, meta-analysis, and network meta-analysis. American J. Obst. Gyneco.

Vallee, J., Wong, Y., Mannino, E., Nordeng, H., & Lupattelli, A. (2021). Association between Antidepressant Treatment during Pregnancy and Postpartum Self-Harm Ideation in Women with Psychiatric Disorders: a cross-sectional, multinational study. Int J. Environ. Res. Public. Health, 18(46), 2-15.

Berard, A., Sheehy, O., Zhao, J-P., Chambers, C., Roth, M., Bozzo, P. et al. (2019). Impact of antidepressant use, discontinuation, and dosage modification on maternal depression during pregnancy. J. Euro. Neuro., 29, 803-812.

Brown, H. K. (2018). Prenatal Selective Serotonin Reuptake Inhibitor Exposure and Child Neurodevelopment: the importance of maternal mental illness. J. American Acad. Child&Adol. Psyc., 57(3), 150-153.

Pawluski, J. L., & Gemmel, M. (2018). Perinatal SSRI medications and offspring hippocampal plasticity: interactions with maternal stress and sex. HORMONES, 17, 15-24. DOI: <10.1007>

Molenaar, N. M., Kamperman, A. M., Boyce, P., & Bergink, V. (2018). Guidelines on treatment of perinatal depression with antidepressants: na internacional review. Aust.&New Zeland J. Psych., 52(4), 320-327.

Field, T., Diego, M., & Hernandes-Reif, M.(2006). Prenatal depression effects on the fetus and newborn: a review. Infant Behavior & Development, 29, 445-455.

Chisolm, M. S., & Payne, J. L. (2016). Management of psychotropic drugs during pregnancy. Thebmj.

Field, T., Diego, M., & Hernandez-Reif, M. (2010). Prenatal Depression Effects and Interventions: a review. Infant Behavior & Development, 33(4), 409-418. 10.1016/j.infbeh.2010.04.005.

Balkowiec-Iskra, E., Mirowska-Guzel, D. M., & Wielgos, M. (2017). Effect of antidepressants use in pregnancy on foetus development and adverse effects in newborns. Ginekologia Polska, 88(1), 36-42.

Pearlstein, T. (2013). Use of Psychotropic Medication during Pregnancy and the Postpartum Period. Women’S Health, 9(6), 605-615.

Goracci, A. et al. (2015). Antidepressant use in pregnancy: a critical review of the risk and benefits. Rev. Psichiatr., 50(3), 118-126.

Camacho, R. S. et al. (2006). Transtornos psiquiátricos na gestação e no puerpério: classificação, diagnóstico e tratamento. Rev. Psiquiatr. Clín., São Paulo, 33(2), 92-102.

Nomura, M. L., & Pinto e Silva, J. L. C. (2007). Riscos e benefícios dos inibidores seletivos da recaptação de serotonina para a depressão durante a gravidez e lactação. Rev. Bras. Ginecol. Obstet., Rio de Janeiro, 29(7). .

Mendes, K. D. S., Silveira, R. C. C. P., & Galvão, M. C. (2008). Revisão integrativa: método de pesquisa para a incorporação de evidências na saúde e na enfermagem. Texto Contexto Enferm., 17(4), 758-764.



How to Cite

SILVA, R. d’Oliveira B.; PITOMBEIRA, M. G. V.; OLIVEIRA, I. C. M. .; PEREIRA, A. de S.; MAIA, F. T. S. R. . Therapies used in pregnant women who present Major Depressive Disorder and its postpartum implications. Research, Society and Development, [S. l.], v. 10, n. 10, p. e34101018071, 2021. DOI: 10.33448/rsd-v10i10.18071. Disponível em: Acesso em: 20 apr. 2024.



Health Sciences