For a few years now, researchers have been examining the impact of prenatal exposure to antidepressants on behavior, risk of psychopathology and long-term neurodevelopmental outcomes. The findings have been mixed. One of the vital significant challenges in conducting this research has been disentangling the results of exposure to an antidepressant from the results of maternal depression (either while pregnant or later within the child’s development).  

Moreover, our data comes from observational, versus randomized, studies; the ladies who selected to take antidepressants while pregnant are distinct in lots of essential ways from women who elect to discontinue antidepressant treatment. Women who take antidepressants while pregnant usually tend to have more severe or recurrent depression than women who selected to discontinue medications. A growing body of literature indicates that exposure to maternal depression while pregnant has long-term effects on children’s development and vulnerability to psychiatric illness. 

In a recent study, Hutchinson and colleagues examined the associations between maternal depressive symptoms, use of prenatal SSRI antidepressant treatment and youngsters’s behavior as much as 12 years of age.  For this prospective longitudinal study, moms were recruited during their second trimester from community (family practice, midwifery) and tertiary referral clinics (reproductive mental health) on the University of British Columbia in Vancouver, Canada as a way to examine the developmental effects of prenatal exposure to SSRI antidepressants. 

At 3 years and 12 years, the Child Behavior Checklist (CBCL) was accomplished by the mother and was used to discover maternal reports of internalizing behaviors (depression, anxiety, somatic complaints) and anxiety problems. When their children were 6 years of age, moms accomplished the MacArthur Health and Behavior Questionnaire (HBQ), which assesses internalizing, externalizing, over-anxious and inattention behaviors.

Participants

Of the unique 191 moms recruited into the study (76 moms with prenatal SSRI treatment), 147 moms were evaluated at 3 years (59 moms with prenatal SSRI treatment), 145 moms at 6 years (56 moms with prenatal SSRI treatment) and 112 moms at 12 years (38 moms with prenatal SSRI treatment). 

Principally there have been three categories of participants: women with histories of depression who used SSRIs while pregnant, women with depression who selected not to make use of SSRIs, and girls who weren’t depressed. Despite treatment, moms who used SSRIs while pregnant had persistently higher levels of depressive symptoms throughout the second and third trimesters, and at 3 years, 6 years and 12 years, in comparison with moms without prenatal SSRI treatment.  

Maternal Depression, But Not Prenatal SSRI Use, Predicted Internalizing Behaviors and Anxiety in Children

Maternal depression throughout the third trimester was related to increased internalizing behaviors at ages 3, 6, and 12. Neither SSRI exposure alone nor an interaction between SSRI exposure and third trimester maternal mood contributed significantly to risk of internalizing behaviors at any time point.  

This was a really fastidiously done study utilizing standardized measures to evaluate maternal depression and child behaviors. While previous studies have suggested that antidepressant exposure may impact children’s behaviors later during childhood, this study observes that prenatal maternal depressive symptoms, not prenatal SSRI exposure, were related to persistently higher levels of internalizing and anxiety behaviors from toddlerhood into pre-adolescence. This study provides reassuring information for ladies with histories of chronic or current depression who’re planning pregnancy.  

Ruta Nonacs, MD PhD

Hutchison SM, Brain U, Grunau RE, Kuzeljevic B, Irvine M, Mâsse LC, Oberlander TF.  Associations between maternal depressive symptoms and selective serotonin reuptake inhibitor antidepressant treatment on internalising and anxiety behaviours in children: 12-year longitudinal study.  BJPsych Open. 2023 Feb 1;9(2):e26.