Antidepressants during pregnancy may affect standard test performance in kids: JAMA

Antidepressants are a primary treatment option for most types of depression. But there are benefits and risks to consider when taking antidepressants during pregnancy. Concerns exist about long-term neuro developmental consequences of prenatal exposure to antidepressants.

A population based study by Dr Jakob Christensen, PhD and team revealed that children whose mothers had taken prescriptions for antidepressants during pregnancy, compared with children whose mothers did not during pregnancy, had a 2-point lower standardized test score in mathematics, which was statistically significant, but had no significant difference in language test scores.

The findings of the study are published in JAMA Network.

The objective of the study was to evaluate whether maternal prescription fill for antidepressants in pregnancy was associated with performance in standardized tests among Danish schoolchildren.

The study was a population-based retrospective cohort study of children born in Denmark between January 1, 1997, and December 31, 2009. The children included had completed a language or mathematics test as part of the Danish National Test Program age 7-17 years. The difference for antidepressants in mathematics and language tests was estimated using linear regression models, adjusted for relevant confounders. Ten sensitivity analyses were performed, including a sibling-controlled analysis.

The results of the study were

• A total of 575 369 children included (51.1% males), 10 198 (1.8%) were born to mothers filling an antidepressant prescription during pregnancy.

• The mean (SD) age of children at the time of testing spanned from 8.9 (0.4) years in grade 2 to 14.9 (0.4) years in grade 8.

• Maternal prescription fill for antidepressants was significantly associated with a poorer performance in mathematics, mean test scores for the group exposed to maternal antidepressant was 52.1 and group not exposed was 57.4, but not in language mean test scores was 53.4 for exposed group and 56.6 for the not exposed group.

• In the sibling-controlled analysis, the adjusted difference mean scores in mathematics was 53.5 in exposed group and 59.0 for the not exposed group was −2.8. In language test, mean test scores for the exposed group: 53.9 and for the not exposed group: 56.6 was −0.3.

Christensen, and team concluded that "In this study of public schoolchildren in Denmark, children whose mothers had filled prescriptions for antidepressants during pregnancy, compared with children whose mothers did not fill prescriptions for antidepressants during pregnancy, had a 2-point lower statistical difference, but had no statistical difference for language test. The magnitude of the difference in the mathematics test score was small and of uncertain clinical importance, and the findings must be weighed against the benefits of treating maternal depression during pregnancy."

Reference: 

Christensen J, Trabjerg BB, Sun Y, Dreier JW. Association of Maternal Antidepressant Prescription During Pregnancy With Standardized Test Scores of Danish School-aged Children. JAMA. 2021;326(17):1725–1735. doi:10.1001/jama.2021.17380