Zoloft and Pregnancy: Is It Safe?

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Last updated Jan. 11, 2018.

Zoloft is one of the most popular antidepressants in the country — more than 37 million prescriptions for the drug are filled every year. However, mixing Zoloft and pregnancy can expose the baby to certain serious risks.

Pregnancy and Mental Health

We’ve talked before about how pregnancy can be hard on your emotional and mental well-being in addition to being hard on your body. The emotional and mental toll can be even harder to deal with if you have a preexisting condition such as depression or anxiety.

These conditions are common, affecting tens of millions of Americans. Women are twice as likely to develop depression as men, and most cases develop between the ages of 25 and 44. Depression and other mental health conditions are commonly treated with therapy and, in many cases, medication. In fact, a recent study found that 25% of women in the U.S. take medication for a mental health condition.

If you’re taking antidepressants and get pregnant, you’ll need to work with your doctor to figure out the best way to proceed. The medications you take while pregnant can affect your growing little one, but that has to be balanced against what you need to stay healthy. You and your doctor can work together to decide whether antidepressant medications are right for you during those 40 weeks.

Many of these types of medications simply haven’t been tested in pregnant women, so their safety is unknown. One antidepressant in particular, however, has been linked to serious birth defects — Zoloft.

Zoloft and Pregnancy Side Effects

Zoloft (sertraline) is a type of “SSRI,” or “selective serotonin reuptake inhibitor.” These drugs are thought to work by preventing your body from reabsorbing serotonin, increasing your levels of that neurotransmitter and improving your mood. SSRIs are the most popular type of antidepressant in the country.

Common SSRI side effects may include:

• nausea
• weight change
• agitation or restlessness
• decreased libido
• headache
• drowsiness
• gastrointestinal problems

Zoloft has also been linked to another serious side effect — birth defects in children born to women who took the drug while pregnant.

Birth Defects Linked to Zoloft

In 1998, a Pfizer (the maker of the drug) report included a dozen reports of birth defects that may have been linked to their mothers’ Zoloft use. In 2014, a Pfizer researcher showed an association between Zoloft and septal heart defects, a disorder that causes holes in the baby’s heart. She also found a link to omphaloceles, a birth defect that causes the baby’s intestines or organs to form outside the belly.

Septal Heart Defects

Small septal heart defects may close on their own, but large ones affect the body’s ability to circulate oxygenated blood. That puts a strain on the baby’s heart and lungs and may cause permanent damage to the blood vessels. It may also affect the baby’s ability to grow and develop normally. Large septal defects need to be closed with open heart surgery, usually performed when the baby is still very young.

Omphaloceles

Small omphaloceles, where only a small bulge of organs protrudes from the baby’s belly, may be treated by gently and slowly pushing the organs back into the belly over a period of time. Once the organs are all the way back inside the belly, a surgeon will close the hole in the belly.

Larger omphaloceles require more long-term treatment. Because of the abnormal development, there may not be room in the baby’s abdomen for all of the organs to fit at once. In that case, surgeons use a technique called “paint and wait.” They’ll coat the organs in an antibiotic cream as your baby’s belly grows around it. Once there’s enough skin to cover the organ sac, surgeons will wrap an elastic band over the organs, which pushes the organs into place over time.

The whole process can take up to a year, after which a surgeon will close the hole.

Zoloft Lawsuits for Birth Defects

Thousands of families have filed lawsuits against Pfizer since 2012, alleging that the drug company knew about the potential risk of birth defects and failed to warn them. They’re seeking compensation for their children’s medical care — congenital heart defects may require multiple expensive surgeries and omphaloceles may require a year or more of care, plus treatment for any ongoing issues.

All of those costs can add up quickly, and the families are claiming that Pfizer should have warned them about the risks. In late 2015, the FDA asked Pfizer to change its label to include a warning about congenital heart defects in children born to mothers that took Zoloft, but potential changes are still in a draft phase.

If you took Zoloft while pregnant and your child was born with a birth defect, you should contact an experienced attorney to learn about your legal rights and options. Safe Birth Project may be able to help.

What should I do if I’m pregnant and taking Zoloft?

If you’re taking Zoloft or any other antidepressant, you should consult your doctor immediately; do not stop taking any medication without talking to your doctor first. Depression can be difficult to manage without medication, and you’ll have to work with your doctor, your therapist, and the rest of your support system to determine what treatment options will work best for you during the beautiful journey of pregnancy.

Ask your doctor about Zoloft and pregnancy and whether a treatment change is an option for you.