Long-Term Effects of Intrauterine Exposure to Antidepressants on Physical, Neurodevelopmental, and Psychiatric Outcomes:

Rommel, Anna‐Sophie; Liu, Xiaoqin; Munk‐Olsen, Trine; Molenaar, Nina M.

doi:10.4088/jcp.19r12965

Cited by 37 publications

(37 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Most studies on antidepressant treatment during pregnancy have so far centered on potential negative childhood outcomes, e.g., congenital malformations, neonatal persistent pulmonary hypertension, and neurodevelopment and psychiatric outcomes [6,7,34]. In contrast, the effectiveness of antidepressants in preventing psychiatric emergencies during pregnancy has not…”

Section: Antidepressant Discontinuation During Pregnancy and Psychiatric Emergency Riskmentioning

confidence: 99%

“…Similarly, antidepressant use during pregnancy is common: Approximately 2% to 8% of pregnant women in Europe [4] and 8% to 13% in the United States of America [5] receive antidepressant prescriptions at some point in their pregnancy. However, concerns have been raised about offspring sequelae of in utero antidepressant exposure [6,7], and, consequently, more than 50% of women discontinue antidepressants during pregnancy [8].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Antidepressant discontinuation before or during pregnancy and risk of psychiatric emergency in Denmark: A population-based propensity score–matched cohort study

et al. 2022

Self Cite

View full text Add to dashboard Cite

Background Women prescribed antidepressants face the dilemma of whether or not to continue their treatment during pregnancy. Currently, limited evidence is available on the efficacy of continuing versus discontinuing antidepressant treatment during pregnancy to aid their decision. We aimed to estimate whether antidepressant discontinuation before or during pregnancy was associated with an increased risk of psychiatric emergency (ascertained by psychiatric admission or emergency room visit), a proxy measure of severe exacerbation of symptoms/mental health crisis. Methods and findings We carried out a propensity score–matched cohort study of women who gave birth to live-born singletons between January 1, 1997 and June 30, 2016 in Denmark and who redeemed an antidepressant prescription in the 90 days before the pregnancy, identified by Anatomical Therapeutic Chemical (ATC) code N06A. We constructed 2 matched cohorts, matching each woman who discontinued antidepressants before pregnancy (N = 2,669) or during pregnancy (N = 5,467) to one who continued antidepressants based on propensity scores. Maternal characteristics and variables related to disease severity were used to generate the propensity scores in logistic regression models. We estimated hazard ratios (HRs) of psychiatric emergency in the perinatal period (pregnancy and 6 months postpartum) using stratified Cox regression. Psychiatric emergencies were observed in 76 women who discontinued antidepressants before pregnancy and 91 women who continued. There was no evidence of higher risk of psychiatric emergency among women who discontinued antidepressants before pregnancy (cumulative incidence: 2.9%, 95% confidence interval [CI]: 2.3% to 3.6% for discontinuation versus 3.4%, 95% CI: 2.8% to 4.2% for continuation; HR = 0.84, 95% CI: 0.61 to 1.16, p = 0.298). Overall, 202 women who discontinued antidepressants during pregnancy and 156 who continued had psychiatric emergencies (cumulative incidence: 5.0%, 95% CI: 4.2% to 5.9% versus 3.7%, 95% CI: 3.1% to 4.5%). Antidepressant discontinuation during pregnancy was associated with increased risk of psychiatric emergency (HR = 1.25, 95% CI: 1.00 to 1.55, p = 0.048). Study limitations include lack of information on indications for antidepressant treatment and reasons for discontinuing antidepressants. Conclusions In this study, we found that discontinuing antidepressant medication during pregnancy (but not before) is associated with an apparent increased risk of psychiatric emergency compared to continuing treatment throughout pregnancy.

show abstract

Section: Antidepressant Discontinuation During Pregnancy and Psychiatric Emergency Riskmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Antidepressant discontinuation before or during pregnancy and risk of psychiatric emergency in Denmark: A population-based propensity score–matched cohort study

et al. 2022

Self Cite

View full text Add to dashboard Cite

show abstract

“…Such prenatal exposure has been associated with an increased risk for altered motor, social‐emotional, language, and cognitive development from infancy to childhood (Brown et al., 2016; Hanley et al., 2013, 2015; Oberlander et al., 2008; Weikum et al., 2012, 2013; Zeskind & Stephens, 2004), as well as affective disorders in adolescence (X. Liu et al., 2017; Malm et al., 2016). However, not all studies are converging (Hermansen & Melinder, 2015) and long‐term physical, neurodevelopmental, and psychiatric outcomes appear to be driven, at least in part, by the underlying maternal mood disorder (Rommel et al., 2020).…”

Section: Introductionmentioning

confidence: 99%

Prenatal antidepressant exposure and sex differences in neonatal corpus callosum microstructure

Campbell

Williams

Björnson

et al. 2021

Developmental Psychobiology

View full text Add to dashboard Cite

Prenatal exposure to selective serotonin reuptake inhibitor (SSRI) antidepressants may influence white matter (WM) development, as previous studies report widespread microstructural alterations and reduced interhemispheric connectivity in SSRI‐exposed infants. In rodents, perinatal SSRIs had sex‐specific disruptions in corpus callosum (CC) axon architecture and connectivity; yet it is unknown whether SSRI‐related brain outcomes in humans are sex specific. In this study, the neonate CC was selected as a region‐of‐interest to investigate whether prenatal SSRI exposure has sex‐specific effects on early WM microstructure. On postnatal day 7, diffusion tensor imaging was used to assess WM microstructure in SSRI‐exposed (n = 24; 12 male) and nonexposed (n = 48; 28 male) term‐born neonates. Fractional anisotropy was extracted from CC voxels and a multivariate discriminant analysis was used to identify latent patterns differing between neonates grouped by SSRI‐exposure and sex. Analysis revealed localized variations in CC fractional anisotropy that significantly discriminated neonate groups and correctly predicted group membership with an 82% accuracy. Such effects were identified across three dimensions, representing sex differences in SSRI‐exposed neonates (genu, splenium), SSRI‐related effects independent of sex (genu‐to‐rostral body), and sex differences in nonexposed neonates (isthmus‐splenium, posterior midbody). Our findings suggest that CC microstructure may have a sex‐specific, localized, developmental sensitivity to prenatal SSRI exposure.

show abstract

“…Our review of rodent studies suggests that results from perinatal exposure to both SSRIs and other common antidepressants may more consistently increase depressive-like, but not anxious behaviors, in offspring. Among studies of outcomes in humans, the majority of studies suggest that prenatal SSRI exposure does not increase risk for internalizing and anxious behaviors in young children, especially when maternal mood is controlled for using stringent analytic approaches (Rommel et al, 2020). Moreover, to date research studying SSRI exposure and depressive behaviors remains limited and needs increased attention.…”

Section: Future Directions and Conclusionmentioning

confidence: 99%

Perinatal selective serotonin reuptake inhibitor (SSRI) and other antidepressant exposure effects on anxiety and depressive behaviors in offspring: A review of findings in humans and rodent models

Hutchison

Mâsse

Pawluski

et al. 2021

Reproductive Toxicology

View full text Add to dashboard Cite

Long-Term Effects of Intrauterine Exposure to Antidepressants on Physical, Neurodevelopmental, and Psychiatric Outcomes:

Cited by 37 publications

References 0 publications

Antidepressant discontinuation before or during pregnancy and risk of psychiatric emergency in Denmark: A population-based propensity score–matched cohort study

Antidepressant discontinuation before or during pregnancy and risk of psychiatric emergency in Denmark: A population-based propensity score–matched cohort study

Prenatal antidepressant exposure and sex differences in neonatal corpus callosum microstructure

Perinatal selective serotonin reuptake inhibitor (SSRI) and other antidepressant exposure effects on anxiety and depressive behaviors in offspring: A review of findings in humans and rodent models

Contact Info

Product

Resources

About