Commonly-prescribed SSRI antidepressants should be given to pregnant women with "great caution" because the drugs could raise risk for miscarriage, premature birth and health problems in both mom and a newborn baby, a new study concludes.

For the study, published in the Oct. 31 issue of Human Reproduction, researchers from several Boston-area hospitals reviewed previously published studies that examined women with depression who took antidepressants while pregnant.

"There are three main points that stand out from our review of the scientific studies on this topic," study author Dr. Adam Urato, chairman of obstetrics and gynecology at MetroWest Medical Center and a maternal-fetal medicine specialist at Tufts Medical Center, said in a press release. "First, there is clear and concerning evidence of risk with the use of the SSRI antidepressants by pregnant women, evidence that these drugs lead to worsened pregnancy outcomes. Second, there is no evidence of benefit, no evidence that these drugs lead to better outcomes for moms and babies. And third, we feel strongly that patients, obstetrical providers, and the public need to be fully aware of this information."

Selective serotonin reuptake inhibitors, or SSRIs, are a popular type of antidepressants that block the reuptake of a brain chemical serotonin, which affects mood and emotional response. Such drugs include Prozac, Zoloft, Paxil and Lexapro.

According to the researchers, antidepressant use has increased 400 percent over the past 20 years, making the drugs the most commonly prescribed medication in the U.S. for people between 18 and 44 years of age -- the childbearing age range for most women.

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The researchers found in their review that many studies showed SSRIs were no more effective, or slightly more effective, than placebo pills for treating depression in pregnant women. Other evidence suggested SSRIs may make it more difficult to get pregnant for women taking fertility treatments.

They review also found evidence of health risks for pregnant women taking antidepressants including an increase in miscarriage and two potentially dangerous conditions, pregnancy-induced hypertension and preeclampsia, especially if use extends beyond the first trimester.

Premature birth was the "most pressing" obstetrical complication in more than 30 studies researchers reviewed. Urato said, "This is a significant finding because we know that babies born before 37 weeks are at risk for many short and long-term health problems."

There was also a "strong signal" of birth abnormalities, most notably between the antidepressant Paxil and heart defects in newborns. In 2005, the FDA asked GlaxoSmithKline to change Paxil's risk factor to demonstrate risk to the fetus, and the Mayo Clinic says the drug is "generally discouraged" during pregnancy.

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Antidepressants during pregnancy: Too risky?