This article is more than 5 years old. Information may no longer be current.

Antidepressant exposure in utero may increase risk for anxiety in children

Maternal use of antidepressants during pregnancy was associated with increased anxiety in offspring, according to study findings in the International Journal of Epidemiology.

“During their childbearing years up to 20% of women experience depression or other mood disorders. An increasing number of pregnant women are prescribed antidepressants which cross the human placenta and the blood-brain barrier,” study researcher Ragnhild Eek Brandlistuen, PhD, of the University of Oslo, Norway and colleagues wrote. “When used in pregnancy, antidepressants alter the central serotonin signaling of the fetus during early brain growth and may contribute to developmental risk. However, untreated maternal depression also alters neonatal serotonin levels.”

Ragnhild Eek Brandlistuen

Researchers assessed maternal mental health and antidepressant use during pregnancy and externalizing and internalizing problems among 29,762 siblings at 18 months and 36 months. Study participants were identified from the Norwegian Mother and Child Cohort Study, a population-based study of Norwegian women giving birth from 1999 to 2010. Mothers completed questionnaires at 17 and 30 weeks gestation, 6 months after birth and until children were aged 3 years. Their responses determined medication use, maternal lifestyle and health and child development.

Approximately 0.8% of the 20,180 siblings with complete data at 18 months were discordant for antidepressant exposure.

Prenatal antidepressant exposure was associated with internalizing behavior problems at 18 months, according to crude unmatched analyses. Analyses of subscales indicated an association with anxiety but not emotional reactivity, somatic complaints or sleep problems.

This finding remained true in crude matched sibling analyses, however, analyses of subscales did not indicate a significant association with anxiety, emotional reactivity, somatic complaints or sleep problems.

Antidepressant use had no effect on child internalizing behavior problems in analyses that adjusted for differences in maternal depression or anxiety during pregnancy, lifetime depression, postpartum depression symptoms, alcohol use during pregnancy and co-medication.

Externalizing behavior problems were not associated with prenatal antidepressant exposure in any analyses.

At age 36 months, prenatal antidepressant exposure was significantly associated with internalizing behavior problems and anxiety, according to crude unmatched regression and sibling-matched analyses.

“Clinically, the finding that maternal history of lifetime depression predicted a long-term disturbance in offspring behavior would encourage a greater use of assessments emphasizing maternal mood and mental health — not only for predicting maternal postnatal adjustment, but also to ensure a positive adjustment of the child,” Brandlistuen and colleagues wrote. – by Amanda Oldt

Disclosure: Brandlistuen reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.