It may be necessary to treat pregnant women experiencing
moderate to severe anxiety with psychotropic medications,
but the risks of treatment to the fetus and the mother
must be compared with the risks of uncontrolled anxiety.
Antenatal anxiety can have negative effects on pregnancy
outcome and the health of the infant. All psychotropic drugs
cross the placenta; however, results are mixed regarding the
impact of SSRIs and benzodiazepines in pregnancy. Some
studies have shown Paxil to be associated with cardiac malformations
in infants, and regular use of SSRIs in the last trimester
has been associated with preterm labor (Avni-Barron
& Wiegartz, 2011). According to Howland (2009), however,
research regarding Paxil’s association with cardiovascular
effects is not conclusive. While antidepressant medications
are largely believed to be safe for use in pregnant women,
a small, yet serious risk of birth defects has been associated
with use of benzodiazepines. This has led to the current recommendation
that SSRI drugs be the preferred choice over
benzodiazepine drugs (Howland, 2009).