Infant growth unaffected by prenatal SSRI use, depression

In utero exposure to selective serotonin reuptake inhibitors and major depression did not affect infant growth at 12 months, including the infant’s weight, length and head circumference, according to new study results published in the American Journal of Psychiatry.

Previous research has indicated that both untreated maternal depression and antidepressant use during pregnancy may lead to adverse birth outcomes and stunted infant growth.

“The rate of growth in infants is the most rapid of any time in their lives, so evaluating growth after prenatal exposure to disease and/or medication exposure is critical,” study researcher Katherine L. Wisner, MD, of Northwestern University, told Psychiatric Annals.

Katherine L. Wisner

Wisner and colleagues examined infants’ physical measurements at birth and again at 2, 12, 26 and 52 weeks. Pregnant women were evaluated at 20, 30 and 36 weeks of gestation. Selective serotonin reuptake inhibitor (SSRI) use was documented since conception, and almost all women in the study receiving SSRIs were treated with a single drug. Blood samples were used to confirm SSRI use, and all depression diagnoses were based on DSM-IV criteria.

Three groups were identified in the study: women unexposed to SSRIs who were not depressed (n=97), women exposed to SSRIs (n=46), and women with major depression who were not exposed to SSRIs (n=31).

Even after adjusting for factors such as anxiety disorder, infant sex and preterm birth, Wisner and colleagues found no significant relationship between prenatal major depression or SSRI use with infant growth. The growth measurements of infants of mothers in the study group were comparable to those of infants in the general population.

“Use of SSRIs is widespread, and women who stop taking them near the time of conception have a high relapse rate,” Wisner said. “Given that depression has its own negative consequences, it’s important to know the effects of both treatment and the lack of treatment. Previously we haven’t had much information on infant outcomes.”

In an accompanying editorial, Barbara L. Parry, MD, of the University of California, said it was encouraging that depression and SSRI use did not have a significant impact on infant growth in the study, suggesting that the factors that govern infant growth are strong enough to withstand major depression and its treatment.

“The next developmental task in this area of investigation is to use the sound methodological techniques provided by these investigators to decipher whether the perturbations of major depressive disorder or antidepressant treatment have long-term effects on the other aspects of infant development, namely neurocognitive and social-emotional growth,” Parry wrote.

For more information:

Parry BL. Am J. Psychiatry. 2013;doi:10.1176/appi.ajp.2013.13010118.

Wisner KL. Am J Psychiatry. 2013;doi:10.1176/appi.ajp.2012.11121873.

Disclosure: See the study for the full list of financial disclosures.