Antidepressants during pregnancy closely associated with Neurodevelopmental problems in kids: JAMA

Neurodevelopmental problems in children are not more likely to occur as a result of antidepressant usage during pregnancy, says an article published in the Journal of American Medical Association - Internal Medicine.

Some research has linked antidepressant usage during pregnancy to neurodevelopmental problems in children. The results, however, could be accounted for by unchecked confounding due to parental mental health, genetics, and environmental variables. Thus, to assess the relationship between antidepressant usage during pregnancy and the neurodevelopmental outcomes of children, Elizabeth Suarez and colleagues carried out this study.

Research Database with cohorts of pregnant people with publicly and privately insured insurance and their offspring were identified. From birth until outcome diagnosis, disenrollment, death, or study conclusion, children were monitored. Between August 2020 and July 2021, analysis was done. The exposure requirements were the administration of antidepressants from gestational week 19 to birth, during the synaptogenesis phase. Children's neurodevelopmental diseases identified using tested methods. Early prenatal exposure was taken into account in sensitivity analysis, and methods for confounding correction included sibling analyses, discontinued comparison, and propensity score fine stratification.

The key findings of the study were:

1. There were 1,45,702 antidepressant-exposed and 30,32,745 unexposed pregnancies among the individuals included in the analysis

2. The mean (SD) age among the antidepressant exposures and non - exposed was 26.2 (5.7) and 24.3 (5.8) years in MAX and 32.7 (4.6) and 31.9 (4.6) years in MarketScan, respectively; and in MAX, which compiled data on race and ethnicity, 72.4% of the antidepressant-exposed.

3. The crude data showed that antidepressant exposure might double the risk of neurodevelopmental sequelae; however, no link was found in the most completely adjusted analysis.

4. The hazard ratios were 0.97 for any neurodevelopmental disorder, 0.86 for autism spectrum disorder, 0.94 for attention-deficit/hyperactivity disorder, 0.77 for particular learning disorders, 1.01 for developmental speech/language disorder, 0.79 for developmental coordination disorder, 1.00 for intellectual disability, and 0.95 for behavioral disorders when comparing siblings who had received antidepressant exposure versus those who had not.

5. For antidepressant classes and medications as well as across exposure windows, results were fairly similar.

Reference: 

Suarez, E. A., Bateman, B. T., Hernández-Díaz, S., Straub, L., Wisner, K. L., Gray, K. J., Pennell, P. B., Lester, B., McDougle, C. J., Zhu, Y., Mogun, H., & Huybrechts, K. F. (2022). Association of Antidepressant Use During Pregnancy With Risk of Neurodevelopmental Disorders in Children. In JAMA Internal Medicine. American Medical Association (AMA). https://doi.org/10.1001/jamainternmed.2022.4268