Pregnant women presented with a health concern are often faced with difficult decisions regarding whether or not to take medications during pregnancy. As all medication exposures during pregnancy pose some risk to the developing fetus, this risk must always be weighed against the potential risk/benefit ratio for both fetus and mother. Depending on the type of medication under consideration for use, the dialog surrounding the risk/benefit ratio can be intense. Specifically, antidepressant medication use during pregnancy has been controversial. In many ways, it could be deemed an ‘unfair controversy’ as the scrutiny encountered by women taking antidepressants likely exceeds that faced by women taking other types of medications for a myriad of different medical illnesses.

In this issue of Neuropsychopharmacology, a new article by Mulder et al (2011) examines the in utero neurobehavioral development of SSRI-exposed infants. The primary aim of this study was to compare behavioral development in a group of fetuses exposed to SSRIs throughout pregnancy compared with a control group of healthy unexposed fetuses. This study examined three groups of participants: (1) low-dose SSRI medication exposed and unmedicated pregnant women with a history of depression/anxiety, (2) women taking average or above average doses of SSRI's with histories of depression/anxiety, and (3) normal controls (pregnant women with no psychiatric history and no medications). The authors conducted a prospective observational study throughout pregnancy and performed detailed ultrasound assessments of fetal behavior during each trimester (T1, T2, T3) including fetal motor behavior, heart rate, and the emergence of behavioral (sleep–wake) states.

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