newsGP - Does taking antidepressants during pregnancy impact children's brains? - RACGP

New research suggests it does not increase the risk of neurodevelopmental disorders in children, but there is an association.

Research published in JAMA Internal Medicine shows that taking antidepressants while pregnant does not increase the risk of children developing neurodevelopmental disorders.

However, the Harvard Medical School crude data reveals an association between antidepressants in pregnancy and neurodevelopmental issues, which could be an important marker for the need for early screening and intervention in exposed children.

The study’s lead author, Dr Elizabeth Suarez, told newsGP the research adds ‘clarity’ to the discussion around antidepressant use during pregnancy.

‘Antidepressants are one of the most commonly used medications in pregnancy and during reproductive years, therefore the safety of antidepressants during pregnancy is of great interest to providers and patients,’ she said.

‘We found that antidepressant use is unlikely to increase the risk of neurodevelopmental disorders in children, and any observed association is likely due to factors associated with antidepressant use, such as the indication [depression, anxiety, etcetera], health and lifestyle factors associated with having depression or anxiety, environmental and genetic risk factors.’.

Previous research has been conflicting about whether antidepressants increase the risk of neurodevelopmental disorders (NDD), autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD).

The authors note that ASD is the most widely studied NDD in relation to antidepressant exposure during pregnancy.

‘Studies using population-based registries in Nordic countries and Canadian provinces [report] estimates of a 20–80% increase in ASD risk with antidepressant exposure,’ they wrote.

More than 145,700 pregnancies were exposed to antidepressants, which included serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors and tricyclic antidepressants

Outcomes studied included ASD, ADHD, specific learning disorders, developmental speech/language disorders, developmental coordination disorders, intellectual disabilities and behavioural disorders

Women using antidepressants during pregnancy had a higher risk of having a child with an NDD than individuals not using antidepressants, but after adjustment for an extensive list of potential confounders, no difference was found

The authors state this points to an increased risk of NDDs owing to factors associated with antidepressant use during pregnancy, but not the medication itself

‘[It] will reassure most women that, should they require an antidepressant during their pregnancy, then [they] do not increase the risk of ADHD and neurodevelopmental issues in their child,’ he said

The authors note that children exposed to antidepressants in pregnancy could be marked for early screening and intervention, with the goal of improving outcomes for NDDs

Associate Professor Polyakov said that while the potential of NDDs in children should be kept in mind, it’s important to remember that depression can have serious effects on a pregnancy

ADHD antidepressants ASD children neurodevelopment pregnancy