venlafaxine, amitriptyline, antidepressants, gestational diabetes, pregnant woman holding tummy with sad face on it

Antidepressants and Gestational Diabetes: What is the Risk?

A new study found an association between taking antidepressants and gestational diabetes risk. The study was performed at CHU Sainte-Justine Medical Center in Montreal, Canada and examined 237,172 pregnancies between 1998 and 2015, using data from the Quebec Pregnancy Cohort. The study was published in BMJ Open

Mothers who took venlafaxine and amitriptyline had a 27 percent and 52 percent increased chance of gestational diabetes, respectively. The drugs citalopram, paroxetine, and sertraline did not have a significant association with gestational diabetes. Overall, antidepressant use was associated with a 19 percent increase in gestational diabetes risk.

In addition, the longer any given antidepressant was taken, the greater the risk. And if a woman was taking more than one antidepressant, the risk increased as well. 

What is gestational diabetes?

Gestational diabetes is diagnosed during pregnancy through a test given by your doctor. Like type 1 and type 2 diabetes, gestational diabetes causes blood sugar levels to become too high.

When you’re pregnant, your body naturally becomes more resistant to insulin so that more glucose is available to nourish your baby. For most moms-to-be, this isn’t a problem. When the body needs additional insulin to process excess glucose in blood, the pancreas secretes more.

But if the pancreas can’t keep up with the increased demand for insulin during pregnancy, blood sugar levels rise too high because the cells aren’t using the glucose. This results in gestational diabetes.

Unlike other types of diabetes, gestational diabetes isn’t permanent. Once the baby is born, your blood sugar will most likely return to normal. However, having gestational diabetes does increase the odds of you developing diabetes in the future.

Other risks involved with gestational diabetes include high blood pressure and C-section delivery. Risks for the baby include low blood sugar and the risk of developing type 2 later in life. 


Study implications

The reason for the link could be that antidepressants are associated with weight gain, insulin resistance, and glucose metabolism issues, all of which can lead to gestational diabetes. There is a correlation but not causation between the two factors.

The study authors make it clear that pregnant women on antidepressants should not abruptly stop taking them, but should work with a doctor on tapering off or getting on a new treatment.

Depression needs to be treated during pregnancy. Not getting the proper treatment for depression comes with its own set of risks, such as functional impairment, worsening depression, hypertension, preterm labor, C-section, postpartum depression, and postpartum psychosis. For the baby, risks include not bonding with the mother as an infant, developmental delay, and altered brain development.

Is it safe to take antidepressants while pregnant?

For each individual mother and her doctor, there should be a careful weighing of the risks, benefits, and alternatives such as cognitive behavioral therapy.

Although there is an increased risk of gestational diabetes with antidepressants, the overall risk is still relatively low. If you are pregnant and taking an antidepressant, talk with your doctor about your options.