What is a major concern when using antidepressants during pregnancy?

A major concern when using antidepressants during pregnancy is the potential fetal exposure effects. Antidepressants, particularly certain classes such as selective serotonin reuptake inhibitors (SSRIs), can cross the placenta and may influence fetal development. Studies have shown that in utero exposure to these medications can be associated with risks such as neonatal withdrawal symptoms, potential cardiac defects, and developmental delays. Therefore, healthcare providers must carefully weigh the benefits of treating maternal depression against the possible risks to the fetus. It is crucial to monitor and assess both the mother's mental health needs and the potential implications for the unborn child when considering antidepressant therapy during pregnancy.

The other choices do not directly relate to the primary concerns of antidepressant use in this context. For instance, while multiple births can occur due to fertility treatments but are not a significant risk associated with antidepressant use, labor pain levels are more associated with the physiological aspects of childbirth rather than medication use during pregnancy, and gestational diabetes has its own risk factors not necessarily linked to antidepressant use.