Antidepressant use during pregnancy is tied to an increased risk of psychiatric illnesses, especially mood disorders, in children, according to a study.
The overall risk is low, though. Only about three per cent of the nearly 905,383 children in the study were diagnosed with a psychiatric disorder by age 16.
But compared to the children of women who took antidepressants before pregnancy but not during, children whose mothers continued taking the medications in pregnancy were 27 per cent more likely to be diagnosed with mood, anxiety, behavioural or autism spectrum disorders.
Lead author Xiaoqin Liu, an epidemiologist at the National Centre for Register-based Research at Aarhus University in Denmark, said the study is the first to look at a wide range of psychiatric disorders, instead of a single psychiatric illness, among children exposed to antidepressants in utero.
The results are in line with some past research, but conflict with other studies, Liu noted. This could be due to differences in study population and sample size, or alternatively, the potential association is modest, he said.
“We would like to stress that our study does not suggest or support that women with depression discontinue medication during pregnancy,” he said.
Our study does not suggest or support that women with depression discontinue medication during pregnancy
Some past research has also found that the children of women with untreated depression during pregnancy have a higher risk of psychiatric disorders and other health issues, raising the question of how much of a child’s risk is tied to the mother’s underlying mental illness and how much to the medications she takes to treat it.
Liu’s team used birth and health registries to follow children born in Denmark between 1998 and 2012 until July 2014, for a maximum of about 16 years of follow-up. They found that almost twice as many children, or 14.5 per cent, were diagnosed with a psychiatric illness if their mother began antidepressants during pregnancy compared with eight per cent whose mothers never used these medications. The incidence of psychiatric disorders in children whose mothers started using antidepressants during pregnancy was 14.5 per cent, among those whose mothers continued prior use of the medications during pregnancy it was 13.6 per cent, and when mothers discontinued the medications before pregnancy, it was 11.5 per cent.
Overall, the risk of psychiatric disorders in children born to mothers who began using antidepressants during pregnancy was 56 per cent higher compared to those whose mothers had never used the drugs, and 64 per cent higher when mothers continued antidepressant use during pregnancy, according to the results published in The BMJ.
“On the one hand, I believe studies using this type of method can be really important for generating hypotheses but they are really poorly suited for actually testing the hypothesis. To me this study doesn’t bring us any closer to finding an actual answer,” said Michael Schoenbaum, senior adviser for mental health services, epidemiology and economics at the US National Institute of Mental Health who was not involved in the research.
“I think that what it is likely to do is make people nervous. Depression is a serious thing. Untreated, it’s dangerous to a mother and child,” Schoenbaum said in a phone interview.
The risk of psychiatric disorders in children did not vary by class of antidepressant a mother used but the highest risk was among children exposed to both selective serotonin reuptake inhibitors (SSRIs) and non-SSRI antidepressants during pregnancy.
Liu and colleagues also found that antidepressants prescribed during the second or third trimester, or over more than one trimester, posed a higher risk of psychiatric disorders.