Monday, October 3, 2022

Antidepressant Use During Pregnancy Not Associated With Neurodevelopmental Risk in Children

Children who were exposed to antidepressants in the womb do not appear to have an increased risk of neurodevelopmental disorders, according to a report published today in JAMA Internal Medicine.

Elizabeth Suarez, M.P.H., Ph.D., of Harvard Medical School and colleagues used national public and private health insurance databases to compile information on mothers who filled a prescription for an antidepressant medication during the second half of pregnancy (a period of marked fetal brain development). The total sample included over 145,000 women who took an antidepressant during the second half of pregnancy and over 3 million who did not. The children of these women were tracked from birth until they were diagnosed with a neurodevelopmental disorder, died, disenrolled, or reached age 14.

The researchers specifically focused on the rates of the following neurodevelopmental disorders in the children: autism spectrum disorder, attention-deficit/hyperactivity disorder, learning disorder, speech or language disorder, developmental coordination disorder, intellectual disability, and behavioral disorder.

Overall, children who were exposed to any antidepressants had a 1.76-fold increased risk of being diagnosed with any neurodevelopmental disorder; this risk was similar regardless of the class of antidepressants taken by the mother (selective serotonin reuptake inhibitors, serotonin norepinephrine uptake inhibitors, and tricyclics), Suarez and colleagues reported. The risk of neurodevelopmental disorders in the children was also similar when limiting the comparison to those whose mothers took sertraline, fluoxetine, bupropion, citalopram, or escitalopram.

However, when the researchers adjusted for multiple variables, including the maternal mental health diagnoses, sociodemographic factors, and lifestyle behaviors (such as smoking and drinking), they found that the neurodevelopmental risk associated with antidepressants dropped to 1.15-fold increased risk of any disorder. The risk was even lower when comparing women who took antidepressants during pregnancy with women who stopped taking antidepressants shortly before pregnancy.

Finally, Suarez and colleagues compared families in which some siblings had been exposed to antidepressants while others had not. There was no evidence of increased risk from antidepressant exposure for any neurodevelopmental disorder when comparing these groups, they reported.

“The results of this cohort study suggest that antidepressant use in pregnancy itself does not increase the risk of neurodevelopmental disorders in children,” Suarez and colleagues concluded. “However, given strong crude associations, antidepressant exposure in pregnancy may be an important marker for the need of early screening and intervention.”

To read more on this topic, see the Psychiatric News article “Special Report: Women’s Reproductive Mental Health—A Clinical Framework.”

(Image: iStock/Mikumi)

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