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The objectives of this study are to i) review the risks of untreated depression and anxiety, ii) review the literature on risks of exposure to antidepressants during pregnancy, iii) discuss the strengths and weaknesses of the different study designs used to evaluate those risks, and iv) provide clinical recommendations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">MEDLINE<\/jats:styled-content>\/PubMed was searched for reports and studies on the risk of first\u2010trimester teratogenicity, postnatal adaptation syndrome (<jats:styled-content style=\"fixed-case\">PNAS<\/jats:styled-content>), and persistent pulmonary hypertension (<jats:styled-content style=\"fixed-case\">PPHN<\/jats:styled-content>) with in utero antidepressant exposure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>While some individual studies suggest associations between some specific major malformations, the findings are inconsistent. Therefore, the absolute risks appear small. <jats:styled-content style=\"fixed-case\">PNAS<\/jats:styled-content> occurs in up to 30% of neonates exposed to antidepressants. In some studies, <jats:styled-content style=\"fixed-case\">PPHN<\/jats:styled-content> has been weakly associated with in utero antidepressant exposure, while in other studies, there has been no association.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Exposures of concern include that of untreated maternal illness as well as medication exposure. It is vital to have a careful discussion, tailored to each patient, which incorporates the evidence to date and considers methodological and statistical limitations. 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