Antidepressant Use during Pregnancy Linked with Child’s Risk of Depression

​The Universities of Turku and Helsinki together with researchers from Columbia University, New York, examined the link between mothers’ prenatal use of selective serotonin reuptake inhibitors (SSRIs) used for blocking the reabsorption of serotonin and the cumulative incidence of offspring diagnoses of depression, anxiety, autism and attention-deficit/hyperactivity disorder (ADHD) from birth to 14 years.

‒ Depression was diagnosed by the age of 15 with 8.2 percent of children exposed to SSRI medication in utero, whereas only 1.9 percent of the control group received the same diagnosis. The clearest difference between the groups was in the age group of 12‒14 years, states the lead author of the study Obstetrician Heli Malm from the Teratology Information Service at the Helsinki University Hospital.

The national register data included nearly 16,000 mothers using SSRIs. Since mother’s psychiatric disorders may have an impact on the development of the child, the mothers of the children in the control group had been diagnosed with a psychiatric disorder but used no antidepressants during pregnancy.

Study Will Cover Adolescence

This is the first study focusing on the associations between prenatal SSRI exposure and the risk of depression in this particular age group.

‒ The results are preliminary and involve uncertain aspects. Even in the oldest age group, children were just about to reach the age when symptoms of depression first start appearing. Also, the study could not rule out the influence of the environment on the children’s development, says Malm.

Results of the study support the results from animal experiments. SSRIs have been proven to cause depression-like behaviour in rodents when exposed to the drug during the sensitive developmental period of central nervous system which is equivalent to human fetal period.

‒ The study will continue to examine adolescence, since that is when the risk of depression can be more reliably evaluated. In addition, it is important to find out if the foetus is especially vulnerable to SSRIs during a specific stage of pregnancy or whether there are differences between drugs when it comes to the safety of the foetus, explains Professor Andre Sourander from the Department of Child Psychiatry at the University of Turku, who led the study in Finland.

Maternal Depression Cannot Be Left Untreated

Using SSRIs for treating depression has increased during the last decades, and almost 4 percent of pregnant women in Finland use them. However, Malm points out that using SSRIs during pregnancy can also be justified from the point of view of both the mother and the child.

‒ Maternal depression cannot be left untreated. The well-being of the mother is a prerequisite for a smooth pregnancy, whereas untreated depression risks the pregnancy as well as the health of the mother and the child. If the SSRIs are clearly helpful in treating the mother’s depression, the medication should not be stopped.

Sourander notes that the research results indicating possible negative effects of the antidepressants and the increased risk of offspring depression are important findings.

‒ In addition to psychosocial care in treating depression during pregnancy, interventions through psychotherapy are important and we should increase their availability, says Sourander.

The study showed no differences between age groups in anxiety diagnosis, autism and the appearance of ADHD. Previous studies have reported inconsistent results about the link between SSRIs exposure and offspring symptoms of autism or ADHD.

The results of the study and the editorial were published in the highly esteemed Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP). The study received funding from the National Institute of Mental Health (NIMH).

Read more:

>> Study Finds Risks for Teens of Mothers Who Took Certain Antidepressants (The Wall Street Journal)

>> Abstract of the study (Journal of the American Academy of Child and Adolescent Psychiatry)

Text: Taru Suhonen
Photo: Hanna Oksanen
Translation: Saara Yli-Kauhaluoma