Postnatal SSRI Treatment may improve Outcomes for Maternal Mental Health

Up to the fifth postpartum year, postnatal depression was linked to worse outcomes for mothers and children, says an article published in the Journal of American Medical Association.

Despite selective serotonin reuptake inhibitors (SSRIs) are advised for the treatment of postnatal depression, there isn't enough information on the long-term effects of SSRI therapy on mothers and children. In order to determine if postnatal SSRI medication affected postnatal depression-related mother and child outcomes across early childhood years, Chaoyu Liu and colleagues conducted this study.

The Norwegian Mother, Father, and Child Cohort research provided the longitudinal data for this cohort research. From 1999 to 2008, pregnant participants were sought out between weeks 17 to 18 and prospectively followed up with following delivery. Analysis of the data was done between December 2021 and October 2022. An Edinburgh Postnatal Depression Scale score of seven or above was required for postnatal depression diagnosis (a binary indication of treatment eligibility). At the sixth postpartum month, the Hopkins Symptom Checklist was employed as a continuous indication of and postnatal depression symptomology. Using self-reported data at postpartum month 6, postnatal SSRI therapy was discovered.

From pregnancy through the fifth postpartum year, maternal outcomes included self-reported depressive symptoms and relationship satisfaction. Mothers' reports of internalizing and externalizing issues, indications of attention-deficit/hyperactivity disorder, and motor and linguistic development at ages 1.5, 3, and 5 were included as the child outcomes. To account for prenatal elements linked to the likelihood of postnatal SSRI exposure, a propensity score adjustment approach was applied.

The key findings of this study were:

A total of 61 081 mother-child pairs were examined, and 8671 (14.2%) of them had postnatal depression.

Of them, 177 (2.0%) had undergone SSRI therapy. A variety of poor outcomes for mothers and children were linked to more severe postnatal depression symptoms.

Analyses that were limited to postnatal depression dyads revealed that postnatal SSRI therapy reduced the unfavorable correlations between postnatal depression and mother relationship satisfaction at postpartum months 6, years 1.5, and 3, as well as for child ADHD at age 5.

Up to five years after childbirth, postnatal SSRI therapy reduced the unfavorable correlations between postnatal depression and maternal depression, partner relationship satisfaction, child externalizing issues, and attention-deficit/hyperactivity disorder.

Reference:

Liu, C., Ystrom, E., & McAdams, T. A. (2023). Long-Term Maternal and Child Outcomes Following Postnatal SSRI Treatment. In JAMA Network Open (Vol. 6, Issue 8, p. e2331270). American Medical Association (AMA). https://doi.org/10.1001/jamanetworkopen.2023.31270