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Although crude results of a study showed risk of neurodevelopmental disorders doubling when exposed to antidepressants during pregnancy, these results were not observed in a fully adjusted analysis.
Antidepressant use during pregnancy does not lead to neurodevelopmental disorders in children, according to a recent study.
Investigators conducted a cohort study to determine an association between antidepressant use and neurodevelopmental disorders. Prior studies have associated antidepressant use during pregnancy with increased risk of neurodevelopmental disorders for children, but parental health status, genetics, and environmental factors were not excluded as potential factors leading to these results.
Data on pregnancies was taken from the Medicaid Analytic eXtract (MAX) and the IBM MarketScan Research Database (Marketscan). Nearly 2 million pregnancies were analyzed from MAX and 1.25 million pregnancies from Marketscan.
From August 2020 to July 2021, children were followed from birth until meeting any of the following criteria: disenrollment, death, diagnosis, or end of study. Participants were aged no older than 14 years by the end of the study period.
Exposure was measured as dispensing of antidepressants at 19 weeks gestational age until birth. Neurodevelopmental disorders were measured through previously created and validated algorithms.
Over 145,000 pregnancies were antidepressant exposed while over 3,000,000 were not antidepressant exposed. The exposed group had an average age of 5.7 years in MAX and 4.6 years in Marketscan. The unexposed group had an average age of 5.6 years in MAX and 4.6 years in Marketscan.
Hazard rations for exposed siblings compared to unexposed siblings were 1.01 for developmental speech disorder, 1.00 for intellectual disability, 0.97 for any neurodevelopmental disorder, 0.95 for behavioral disorders, 0.94 for attention-deficit/hyperactivity disorder, 0.86 for autism spectrum disorder, 0.79 for developmental coordination disorder, and 0.77 for specific learning disorders.
Risk of neurodevelopmental outcomes seemed to double in initial results, but this association was not apparent in fully adjusted analysis. This suggests the need for early screening following antidepressant use during pregnancy but does not directly correlate antidepressant use with increased risk of neurodevelopmental disorders in children.
Suarez EA, Bateman BT, Hernández-Díaz S, Straub L, Wisner KL, Gray KJ, et al. Association of antidepressant use during pregnancy with risk of neurodevelopmental disorders in children. JAMA Intern Med. 2022. doi:10.1001/jamainternmed.2022.4268