Exposure to antidepressants in utero may increase the risk of affective disorders in offspring

Major depressive disorder is very common, as every fifth man experiences an episode at some point in his life and is almost twice as common in women than in men. Antidepressants are usually given as first-line treatment, including during pregnancy, either to prevent recurrence of depression or as an acute treatment in new patients. The use of antidepressants during pregnancy is widespread and since antidepressants cross the placenta and blood-brain barrier, there are concerns about the potential long-term effects of intrauterine exposure to antidepressants in the unborn child.

Using Danish national registries to track more than 42,000 unborn babies born during 1998-2011. By age 18, researchers at Icahn School of Medicine on Mount Sinai investigated whether exposure to antidepressants in the womb would increase the risk of developing an affective disorder such as depression and anxiety in a child. In a study published on April 5 in Neuropsychopharmacology, scientists have found that children whose mothers continued antidepressants during pregnancy have a higher risk of affective disorders than children whose mothers stopped taking antidepressants before pregnancy.

However, to understand whether the underlying disorder that caused the antidepressant or the drug itself was associated with a child’s risk of developing an affective disorder, they also studied the effect of using paternal antidepressants during pregnancy and the like, found that children of fathers taking antidepressants during pregnancy is a higher risk of affective disorders. Therefore, the research team speculates that instead of an intrauterine effect, the observed association is most likely due to the parental mental illness on which the use of antidepressants is based.

“Approximately half of women who use antidepressants before pregnancy decide to discontinue use before or during pregnancy due to concerns about the negative consequences for their child,” said Dr. Anna-Sophie Romel, an instructor in the Department of Mountain Psychiatry at Icahn Sinai and the first author of the paper. “Our research does not provide evidence of a cause-and-effect relationship between in-utero antidepressant exposure and affective disorders in the child. Thus, while other long-term effects of intrauterine antidepressant exposure need to be investigated, our work supports continued antidepressants for women with severe symptoms or high risk. relapse, because untreated psychiatric illness during pregnancy can have negative consequences for the health and development of the child. Women and their health care providers should carefully weigh all treatment options and jointly decide on the best course of action. “


Mount Sinai Hospital / Mount Sinai Medical School

Journal reference:

Rommel, AS., and others. (2021) Long-term prenatal effects of antidepressant use on the risk of affective disorders in offspring: a registry-based cohort study. Neuropsychopharmacology. doi.org/10.1038/s41386-021-01005-6.