Introduction and Purpose: Perinatal depression is a common and serious condition affecting maternal and child health. Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs) and serotonin–norepinephrine reuptake inhibitors (SNRIs), are widely used despite ongoing safety concerns. This review aims to evaluate current evidence on the safety and effectiveness of antidepressant treatment during pregnancy and the postpartum period to support individualized clinical decision-making in the management of perinatal depression. Methods: A narrative systematic review of population-based cohort studies, systematic reviews, and meta-analyses published between 2014 and 2025 was conducted using PubMed. Results: The evidence indicates that SSRIs and SNRIs exposure during pregnancy is associated with small increases in the risk of preterm birth, neonatal adaptation syndrome, postpartum hemorrhage, and rare outcomes such as persistent pulmonary hypertension of the newborn, particularly with late-pregnancy exposure. Absolute risks remain low, and associations with neurodevelopmental disorders largely attenuate after adjustment for familial and maternal psychiatric factors. Postpartum antidepressant treatment is consistently associated with sustained improvements in maternal mental health and functional outcomes. Conclusions: Current evidence supports individualized risk–benefit assessment when considering antidepressant use during the perinatal period. Maintaining maternal mental health is essential, and treatment decisions should consider illness severity, timing of exposure, and patient preferences.
Horabik et al. (Fri,) studied this question.