Using Antidepressants During Pregnancy May Affect Child’s Mental Health

September 7, 2017

AARHUS, Denmark -- September 7, 2017 -- In utero exposure to antidepressants appears to be associated with increased risk of psychiatric disorders, according to a study published in the British Medical Journal (BMJ).

Xiaoqin Liu, MD, Aarhus University, Aarhus, Denmark, and colleagues analysed data from 905,383 children born in Denmark between 1998 and 2012 with the aim of exploring the possible adverse effects of the mother’s use of antidepressants during her pregnancy. The study followed the children until 2014, where some of the children were aged 16 to 17 years.

Of the children in the study, 32,400 developed a psychiatric disorder later in life. Some of these children were born to mothers who were on antidepressants during their pregnancy, while other children had not been exposed to medication.

“When we look at children born to mothers who discontinued and continued antidepressant treatment during pregnancy, we can see an increased risk of developing a psychiatric disorder if the mothers continued antidepressant treatment while pregnant,” said Dr. Liu.

More specifically, the researchers divided the children into 4 groups depending on the mother’s use of antidepressants before and during pregnancy. The children in group 1 had not been exposed to antidepressants in the womb. In group 2, the mothers had been taking antidepressants up until the pregnancy, but not during. In group 3, the mothers were using antidepressants both before and during the pregnancy. Group 4 consisted of children, whose mothers were new users of antidepressants and had started taking the medication during the pregnancy.

Results showed an increased number of children with psychiatric disorders in the group in which the mothers had been using antidepressants during their pregnancy. Approximately twice as many children were diagnosed with a psychiatric disorder in group 4 (14.5%) than in group 1 (8%). In groups 2 and 3 respectively, 11.5% and 13.6% were diagnosed with a psychiatric disorder at age 16 years.

The researchers took into account that heritability also plays a part in determining who will be diagnosed with a psychiatric disorder, and that it is not just a question of being exposed to antidepressants in the womb.

“We chose to conduct the study on the assumption that psychiatric disorders are highly heritable,” Trine Munk-Olsen, Aarhus University. “For this reason, we wanted to show that is too narrow if you only look at autism, which is what many previous studies have done. If heritability plays a part, other psychiatric disorders such as depression, anxiety, ADHD [attention-deficit/hyperactivity disorder]-like symptoms would also appear in the data.”

Indeed, the study also showed that the increase covers not only autism but also other psychiatric disorders such as depression, anxiety, and ADHD. Thus it becomes clear that the mother’s underlying psychiatric disorder matters in relation to the child’s mental health later in life. At the same time, it cannot be ruled out that the use of antidepressants further increases the risk of psychiatric diseases in the child.

“Our research shows that medication seems to increase the risk, but that heritability also plays a part,” said Dr. Munk-Olsen.

Some women might be able to discontinue treatment with the medication while pregnant. However, the researchers also acknowledge that some women need medication and stress that the consequences of an untreated depression are severe and can lead to serious consequences to both mother and child.

The most important message is that we ensure and safeguard the mental well-being of the pregnant women, and for some women, this involves the use of antidepressants.

“These women should not feel guilty about taking antidepressants,” said Dr. Munk-Olsen. “Even though there is an increased risk of the child developing a psychiatric disorder later in life, our research shows that we cannot blame medication alone. Heritability also plays a part.”

Reference: https://doi.org/10.1136/bmj.j3668

SOURCE: Aarhus University

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