Pediatric Speech, Language Disorders Linked to Prenatal Antidepressant Exposure

This finding may have implications for understanding associations between SSRIs and child development.

Children appear to have a slight increased risk of speech/language disorders if their mothers took selective serotonin reuptake inhibitors (SSRIs) for at least 2 months during pregnancy, even after accounting for their depression, suggests a recent study. Tables in the supplemental data, however, suggest this increased risk occurs primarily in boys.

Alan S. Brown, MD, MPH, of New York Psychiatric Institute in New York City and colleagues examined the records of 845 345 mothers and their children, excluding multiples, in Finland between 1996 and 2010. Among the children, 15 596 had been exposed to SSRIs during gestation, 9537 had mothers with depression or a related psychiatric diagnosis who did not take SSRIs or any other psychotropic medication, and 31 207 had mothers who did not take SSRIs and had no psychiatric diagnosis.

The researchers identified 829 cases of speech/language disorders, diagnosed at a mean of 4.4 years old, and 187 cases of learning disorders, diagnosed at a mean of 2.7 years old. The 285 cases of motor disorders were diagnosed at a mean 2.4 years old. No differences existed among the 3 groups for learning disorders or motor disorders.

However, children whose mothers filled at least 2 prescriptions of SSRIs showed a 37% increased risk of speech/language disorders compared to the children of mothers with an untreated depression diagnosis.

“This finding is particularly noteworthy because these women were more likely to have taken these medications and were exposed for a longer period and to larger amounts of SSRIs during pregnancy compared with women who filled only 1 prescription,” the authors wrote. “In the whole sample, irrespective of the number of purchases, the risk of speech/language disorders was increased among offspring of mothers who used SSRIs during pregnancy as well as offspring of mothers diagnosed as having depression or other psychiatric disorders who did not take SSRIs compared with offspring of mothers with neither SSRI use nor psychiatric diagnoses.”

Most previous studies have also found no association between prenatal SSRI exposure and learning or motor disorders, although one other found slight concerns related to language development.

Among the limitations of this study were the inability to consider the severity of mothers’ depression or maternal alcohol use, potential residual confounding from other unmeasured factors, and the inability to adjust the results for various other factors that could affect child development.

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Brown AS, Gyllenberg D, Malm H, et al. Association of Selective Serotonin Reuptake Inhibitor Exposure During Pregnancy With Speech, Scholastic, and Motor Disorders in Offspring. JAMA Psych. 2016;73(11):1163-1170. doi:10.1001/jamapsychiatry.2016.2594.