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No Causal Link Between Prenatal Antidepressant Use and Affective Disorders in Offspring
Although children whose mothers continued antidepressant use during pregnancy were at higher risk of affective disorders compared with children whose mothers stopped taking antidepressants before pregnancy, the increased risk was likely not due to the medication itself, according to a study published online ahead of print in Neuropsychopharmacology.
“As similar associations were observed in children whose fathers continued antidepressant use across the pregnancy period, the observed association may be attributable to the underlying parental psychopathology,” researchers reported, “rather than the direct intrauterine exposure to antidepressants.”
To investigate the link between intrauterine antidepressant exposure and affective disorders such as depression and anxiety in offspring, researchers followed 42,988 children from birth to 18 years old. Children were categorized into 2 groups for the study: those whose mothers used antidepressants before and during pregnancy, and those whose mothers used antidepressants before pregnancy but discontinued use during the pregnancy.
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Among the children, 1538 were diagnosed with affective disorders, according to the study. Children whose mothers continued antidepressants during pregnancy had a higher risk of affective disorders: researchers reported a hazard ratio of 1.20.
To probe potential confounding, the study considered paternal antidepressant use during pregnancy. Children whose fathers continued antidepressant use during pregnancy also had a higher risk of affective disorders, researchers found. The hazard ratio of an affective disorder diagnosis with paternal antidepressant use during pregnancy was 1.29.
“Our study does not provide evidence for a causal relationship between in-utero exposure to antidepressants and affective disorders in the child,” said study first author Anna-Sophie Rommel, PhD, an instructor in the department of psychiatry at Icahn Mount Sinai, New York, New York.
“So, while other long-term effects of intrauterine exposure to antidepressants remain to be investigated, our work supports antidepressant continuation for women with severe symptoms or a high risk of relapse because untreated psychiatric illness during pregnancy can have negative consequences on the health and development of the child.”
—Jolynn Tumolo
References
Rommel AS, Momen NC, Molenaar NM, Liu X, Munk-Olsen T, Bergink V. Long-term prenatal effects of antidepressant use on the risk of affective disorders in the offspring: a register-based cohort study. Neuropsychopharmacology. 2021 April 5;[Epub ahead of print].
