Maternal antidepressant use prior to and during pregnancy may be associated with the highest risk for psychiatric disorders in children, according to a study published in the British Medical Journal.
Investigators from the National Center for Register-based Research at Aarhus University in Denmark evaluated the association between in utero antidepressant exposure and psychiatric disorder risk in offspring by analyzing data from 905,383 children born between 1998 and 2012.
The offspring were categorized into 4 mutually exclusive groups according to their mothers’ antidepressant use within 2 years before and during pregnancy: an unexposed group; a new user group (for antidepressant use during pregnancy only); an antidepressant discontinuation group (for antidepressant use before but not during pregnancy); and an antidepressant continuation group (for antidepressant group both before and during pregnancy).
Overall, 32,400 offspring were diagnosed with psychiatric disorders. The weighted 15-year cumulative incidence of psychiatric disorders in the offspring was 8.0% (95% CI, 7.9%-8.2%) for the unexposed group, 14.5% (10.5%-19.8%) for the new user group, 11.5% (10.3%-12.9%) for the antidepressant discontinuation group, and 13.6% (11.3%-16.3%) for the antidepressant continuation group.
The risk for psychiatric disorder was also highest among offspring whose mothers used both selective serotonin reuptake inhibitor (SSRI) and non-SSRI antidepressants. There was also an increased risk for psychiatric disorder in children whose mothers continued their antidepressant use during pregnancy compared with mothers who discontinued treatment.
Because this was an observational study, the researchers could not confirm any causal link between antidepressant exposure and psychiatric disorder diagnosis. However, the researchers concluded that “focusing solely on a single psychiatric disorder among offspring in studies of in utero antidepressant exposure may be too restrictive.”
Liu Z, Agerbo E, Ingstrup KG, et al. Antidepressant use during pregnancy and psychiatric disorders in offspring: Danish nationwide register based cohort study. BMJ. 2017;358:j3668.