Sertraline in Pregnancy — Is It Safe?
Last reviewed: · Source: US FDA drug label database
Sertraline in pregnancy requires careful assessment of risks vs benefits — stopping antidepressants without medical advice is often more harmful than continuing.
Is it safe to take Sertraline with Pregnancy?
Sertraline is one of the most studied antidepressants in pregnancy and is often considered a preferred SSRI option when treatment is needed. The decision to continue or stop sertraline in pregnancy must be made with your doctor — untreated depression and anxiety in pregnancy carry their own risks to mother and baby. Sertraline has a weak signal for cardiac septal defects in some studies, but the absolute risk is very small. Near-term use can cause neonatal adaptation syndrome (temporary irritability, tremor, feeding difficulties in the newborn — not harmful long-term).
How do Sertraline and Pregnancy interact?
Sertraline crosses the placenta. It inhibits SERT (serotonin reuptake transporter). Third-trimester exposure is associated with neonatal adaptation syndrome (temporary SSRI withdrawal effects in newborn) in approximately 30% of cases. The syndrome is self-limiting and not associated with long-term harm. Persistent pulmonary hypertension of the newborn (PPHN) is a rare risk associated with SSRI use after 20 weeks (estimated risk 2-3 per 1000, vs 1-2 per 1000 in unexposed).
Data sourced from the US Food and Drug Administration (FDA) drug label database: NICE guideline CG192 — antenatal and postnatal mental health; OpenFDA sertraline drug label.
Who should be careful?
Women with moderate to severe depression should not stop antidepressants without medical review — the risk of relapse may be greater than medication risk. Women with mild depression may be candidates for dose reduction or switching to psychological therapy. All decisions should involve your GP, obstetrician, and mental health team.
What if I've already taken Sertraline and Pregnancy?
If you are taking sertraline and find out you are pregnant, do not stop suddenly. Contact your GP to discuss — an individualised plan will be made.
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Frequently Asked Questions
Can I take sertraline in pregnancy?
This is an individual decision. Sertraline is one of the preferred antidepressants in pregnancy when treatment is needed. Stopping without medical advice can be more harmful than continuing. Discuss with your GP.
Does sertraline cause birth defects?
The evidence is reassuring but not conclusive. Some studies show a very small signal for cardiac septal defects; others do not. The absolute risk, if any, is very small. Untreated maternal depression also carries risks.
What happens if I take sertraline in the third trimester?
About 30% of babies exposed to SSRIs near birth develop neonatal adaptation syndrome — temporary irritability, tremor, feeding difficulties. This is self-limiting, not dangerous long-term, and does not mean you should stop suddenly.
What is the safest antidepressant in pregnancy?
Sertraline is generally considered the best-studied and lowest-risk SSRI in pregnancy. Fluoxetine and citalopram are also used. All decisions should involve your mental health team and obstetrician.