Talk to your doctor about taking antidepressants during pregnancy, and consider a drug-free alternative.

Some women may want to reconsider using antidepressants while pregnant.

RODALE NEWS, EMMAUS, PA—Approximately one fifth of women suffer from depression during pregnancy, putting them and their babies' health at risk. Yet, those women must weigh their emotional health against the risks of taking antidepressants during pregnancy, which a new study published in the British Medical Journal suggests could lead to congenital heart defects.

THE DETAILS: The study authors collected data from four Danish health registries on 496,881children born between 1996 and 2003, including their mothers' use of antidepressants one month before to four months after they became pregnant. All tolled, 1,370 infants out of the total study sample had been exposed to antidepressants, and among those children, 7 percent were born with defects, compared with 5 percent of unexposed infants. The most significant problems were septal heart defects, in which babies are born with holes in the upper or lower chambers of their hearts. Of the exposed infants with septal heart defects, 2.1 percent had mothers who'd taken a combination of antidepressants, and 0.9 percent had mothers who'd taken one. The antidepressant most prevalently linked to the disorder was sertraline (Zoloft), followed by citalopram (Celexa), fluoxetine (Prozac), and paroxetine (Paxil or Seroxat).

WHAT IT MEANS: Taking antidepressants during pregnancy carries not just the risk of septal heart defects for babies, but also, as previous research has found, of gastrointestinal problems and how a baby's skull is formed. Taking antidepressants during the third trimester can also lead to preterm births, says John Grohol, PsyD, founder of the website PsychCentral.com.

However, untreated depression during pregnancy leads to a higher risk for postpartum depression, and it can interfere with the cognitive and emotional development of the child, lead to sleep problems, and increase the risks of mental and medical disorders later in life. It's important, the authors write, to weigh the risks of the medication with those of the depression. "Pregnant women should definitely talk to their doctor about the fact that they're on antidepressants," says Dr. Grohol. Even if you're considering getting pregnant, it's worth discussing, because you can't simply stop taking these drugs. You need to get weaned off of them, says Dr. Grohol, and that can take anywhere from six to eight weeks.