Neonatal Growth Outcomes at Birth and one Month Postpartum Following In Utero Exposure to Antidepressant Medication

School of Psychology, Deakin University, Melbourne, Victoria, Australia.
Australian and New Zealand Journal of Psychiatry (Impact Factor: 3.41). 05/2010; 44(5):482-7. DOI: 10.3109/00048670903559593
Source: PubMed


Method: A prospective case-control study recruited 27 pregnant women taking antidepressant medication and 27 matched controls who were not taking antidepressant medication in pregnancy at an obstetric hospital in Melbourne, Australia. Of the 27 women taking medication, 25 remained on medication in the third trimester. A purpose-designed self-report questionnaire and the Beck Depression Inventory-II were completed in pregnancy, after birth and at one month postpartum. In addition information was collected on exposed and non-exposed infants including Apgar scores, birthweight/length/head circumference and gestational age at birth. Weight/length/head circumference was again collected at 1 month of age. Results: Infants exposed to antidepressants in utero were eightfold more likely to be born at a premature gestational age, had significantly lower birthweight and were smaller in length and head circumference than non-exposed infants. There was no association between birth outcomes and maternal depression. At 1 month, the difference in weight in the exposed group became significantly greater than the control group. Conclusion: Antidepressant exposure in utero may affect gestational age at birth and neonatal outcomes independently of antenatal maternal depression. Further studies are needed to examine whether these findings vary according to the type of antidepressant prescribed and follow up growth and development in exposed infants beyond 1 month.

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    • "By contrast, a small case-control study of 27 pregnant women who took antidepressant medications for diagnosed major depression and 27 matched controls with depression severity assessed using the Beck Depression Inventory (second edition)197 showed an increased risk of low birth weight (OR 8.33, 95% CI 1.11–62.67) and significantly lower postpartum body weight, length, and head circumference measured at 1 month postdelivery with antenatal antidepressant exposure.165 There was no significant association between depressive symptoms, smoking, or alcohol use and risk of low birth weight or subsequent infant-growth measures, suggesting an independent effect of medication exposure. "
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    • "It can be concluded from studies on psychotropic medication that, to minimize effects on longer term child development, single agents should be considered when treating maternal mental illness in pregnancy, keeping doses as low as is feasible for effective treatment. There is an urgent need for further studies to delineate risks for specific agents so that more informed choices can be made [124-126]. When considering the use, and hence exposure, to antidepressants in pregnancy, the issues relevant to child development and mental health outcomes are not just those that relate to exposure per se but also to the impact of untreated maternal mental illness. "
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