Original Articles
Follow-up of children of depressed mothers exposed or not exposed to antidepressant drugs during pregnancy*

Presented in part at the First International Conference on Women's Mental Health held in March 2001 in Berlin, Germany.
https://doi.org/10.1067/mpd.2003.139Get rights and content

Abstract

Objective To compare the structural growth and developmental outcome of children born to mothers diagnosed with major depressive disorder during pregnancy who were exposed or not exposed to selective serotonin reuptake inhibitors (SSRIs) in utero. Study design Children whose mothers were diagnosed with major depressive disorder in pregnancy and elected not to take medication (n = 13) were compared with children of depressed mothers treated with SSRIs (n = 31) on birth outcomes and postnatal neurodevelopmental functioning between ages 6 and 40 months. Children underwent blinded standardized pediatric and dysmorphology examinations and evaluations of their mental and psychomotor development with the use of the Bayley Scales of Infant Development (BSID II). Results The Bayley mental developmental indexes were similar in both groups. Children exposed to SSRIs during pregnancy had lower APGAR scores and scored lower on the Bayley psychomotor development indexes and the motor quality factor of the Bayley Behavioral Rating Scale than unexposed children. Conclusions The findings that SSRIs during fetal development might have subtle effects on motor development and motor control are consistent with the pharmacologic properties of the drugs. (J Pediatr 2003;142:402-8).

Section snippets

Methods

Women who were in treatment in the Women's Wellness Clinic or with other clinicians and who met DSM-IV criteria17 for Major Depressive Disorder during pregnancy were invited to participate in the follow-up study. They were recruited before or during pregnancy (71%) or after delivery (29%). The study was approved by the Panel on Human Subjects in Medical Research at Stanford University. All women signed consent forms that contained a description of the content and purpose of the study, with one

Results

The proportion of prospectively/retrospectively recruited women was similar in both experimental groups (χ2 =.59; P =.44 ). There were no differences between prospectively and retrospectively studied patients on any of the demographic or outcome variables.

Discussion

The current study found that children exposed to SSRI antidepressant drugs in utero did not differ on most birth outcome and follow-up measures from children of depressed mothers who elected not to take medication during pregnancy. Drug-exposed newborn infants were found to have lower APGAR scores. At follow-up examination, the mental development of drug-exposed children was similar to that of unexposed children. However, we found evidence that prenatal SSRI exposure may have subtle effects on

Acknowledgements

We thank the women who participated in this study.

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    Reprint requests: Regina C. Casper, MD, Stanford University, Department of Psychiatry and Behavioral Sciences, 401 Quarry Rd, Room 2365, Stanford University School of Medicine, Department of Psychiatry and Behavioral Sciences, Stanford, CA 94305-5723. E-mail: [email protected]

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