#VisualAbstract: In Utero Antidepressants and Neurodevelopmental Outcomes in Kindergarteners

1. Children with in utero exposure to selective serotonin reuptake inhibitors (SSRIs) or serotonin norepinephrine reuptake inhibitors (SNRIs) demonstrated greater risk for developmental vulnerability.

2. The Early Development Instrument (EDI) may help clinicians identify at-risk children exposed to in utero antidepressants who may benefit from early childhood intervention.

Evidence Rating Level: 2 (Good)

Study Rundown: Few studies have examined the long-term neurodevelopmental effects of prenatal exposure to antidepressants and have largely had inconclusive results. Some studies have found that in utero antidepressant exposure may increase the risk of language and cognitive deficiencies and behavioral disorders whereas other studies have found no such correlation. To further investigate the neurodevelopmental effects of in utero antidepressant exposure, the authors of the present study used a Canadian population-based cohort to evaluate children’s scores on the Early Development Instrument (EDI) in kindergarten, a teacher-completed questionnaire with 5 domains. Mothers with a prenatal mood or anxiety disorder were separated into 2 groups – those who took SSRIs and/or SNRIs during pregnancy and those who did not. They found that in utero antidepressant exposure increased the risk of developmental vulnerability in the language and cognitive development domain and also increased the risk of overall vulnerability in 2 or more domains. Although this study does not take into account disease severity and how that may affect neurodevelopmental outcomes, the use of a standardized developmental assessment may allow pediatricians to identify children who may be suffering from the developmental consequences of in utero antidepressant exposure.

Click to read the study in Pediatrics