Two Studies: Mom's Anti-Depressant Tied To Newborns' Health Problems

Two recent studies report risks associated with anti-depressant and other psych med use during pregnancy and how that impacts offspring.

First, a Norwegian study appearing in the British journal BJOG looked at 38,602 kids born between 2000 and 2005 and found:

"Children of mothers who used antidepressants during pregnancy showed increased healthcare use during the first year of life, independent of the mother's healthcare use. The relative risk of more than two visits to general practitioners was 1.5 (95% confidence interval, CI: 1.3–1.8) in the continuous antidepressant users group and 1.3 (95% CI: 1.2–1.5) in the group of children whose mothers stopped taking medication. In both study groups there was a trend towards more drug use for infections and inflammation compared with the control group. Children continuously exposed to antidepressants had an increased risk of cardiac interventions such as cardiovascular surgery or heart catheterisation, relative risk of 5.6 (95% CI: 1.8–17.4). The risk of physiotherapy was twice as high in the antidepressant group compared with the control group (relative risk 2.0; 95% CI: 1.5–2.6).

"Conclusion: Antidepressant use during pregnancy is associated with increased child healthcare utilisation and increased risk of major cardiac interventions in early childhood."

Almost six times the risk of needing invasive cardiac procedures is an official "Wow." The researchers told Reuters, however, that the mothers' depression might play a role in all of this:

"It's possible that mothers' depression itself was a factor here, according to Ververs' team. Past studies have found that depressed mothers tend to take their children to the doctor more often than other mothers do.

"Compared with other mothers, Ververs and her colleagues note, depressed moms may find it more difficult to cope with problems like respiratory ills and digestive symptoms."

Depression might explain the office visits, but it sure wouldn't explain the need for cardiac procedures. They did tell the wire service that the evidence supports fetal heart screening for mothers who use anti-depressants throughout a pregnancy.

Separately, a study in the journal Women's Health Issues in September (and brought to my attention by a reader) examined possible links between maternal depression, psych med use during pregnancy and preterm deliveries. Researchers found:

"The odds of overall PTD [preterm delivery] was increased among women who used psychiatric medication during pregnancy and had either elevated levels of depressive symptoms at mid-pregnancy (adjusted odds ratio [AOR], 2.0; 95% confidence interval [CI], 1.1–3.6) or a history of depression before pregnancy (AOR, 1.6; 95% CI, 1.1–2.5). The combination of psychiatric medication use in pregnancy and depression, before pregnancy, or within pregnancy was most strongly linked to a medically indicated delivery before 35 weeks' gestation (AOR, 2.9 and 3.6, respectively). Conclusions

"There are at least two plausible explanations for these findings. First, psychiatric medication use in pregnancy may pose an excess risk of PTD. Second, medication use may be an indicator of depressive symptom severity, which is a direct or indirect (i.e., alters behavior) contributing factor to PTD."

The study examined 3,019 women in Michigan.

Plain and simple, the evidence continues to mount that anti-depressant and psych med use during pregnancy poses significant risks to a child. Clearly, depression--past or present--is no friend to fetuses either, so the tricky question about how to treat all of this remains unclear.