Antidepressant Use in Pregnancy Linked to Speech/Language Disorders

A study published in JAMA Psychiatry has concluded that infants born to mothers who use selective serotonin reuptake inhibitors (SSRIs) during pregnancy are at higher risk for speech and language disorders during childhood.¹

Study Results

The observational cohort study, led by Alan S. Brown, MD, MPH, professor of psychiatry and epidemiology at Columbia University Medical Center, investigated whether maternal use of SSRIs during pregnancy would influence the speech, language, motor, or scholastic abilities of offspring.

The group analyzed population-based registry data from 56,340 Finnish children born between 1996 and 2010. The children were divided into 3 groups:

• Group 1: Children born to mothers diagnosed with depression-related psychiatric disorders who purchased SSRIs at least twice during pregnancy (n = 15,596)
• Group 2: Children born to mothers diagnosed with depression-related psychiatric disorders who did not purchase SSRIs during pregnancy (n = 9537)
• Group 3: Children born to mothers with no history of depression-related psychiatric disorders or purchasing SSRIs (n = 31,207)

After following the children for 14 years, the authors found that the children in Group 1 were at 37% and 63% higher risk for a speech/language disorder than the children in Groups 2 and 3, respectively. There was no difference among groups in motor or scholastic abilities.

Related Statistics

This study—published on the heels of a Swedish study showing that newborns of mothers exposed to SSRIs during pregnancy are more likely to require neonatal care² and a Canadian study showing a higher risk for autism in the offspring of mothers who took SSRIs during the second or third trimester³—highlights the need to educate pregnant women about the potential risks of taking these medications. Further study is certainly warranted.

Although scientists disagree on the number of women taking antidepressants during pregnancy, there is no doubt that some pregnant women take them. The percentage of Americans older than 20 years of age taking antidepressants nearly doubled between 1999 and 2012.⁴

Implications

The question of whether to continue to take SSRIs or other antidepressants while pregnant needs to be answered on a case-by-case basis. Although psychotherapy can be an effective treatment tool for individuals with mild to moderate depression, for those with more severe depression, discontinuing antidepressants may ultimately cause more harm. Untreated or undertreated psychiatric conditions can have dire consequences for both the woman and her child, so it is incumbent on the practitioner to engage in a discussion with pregnant patients about all potential treatment options for depression.

References

1. Brown AS, Gyllenberg D, Malm H, et al. Association of selective serotonin reuptake inhibitor exposure during pregnancy with speech, scholastic, and motor disorders in offspring. JAMA Psychiatry. 2016;73(11):1163-1170. doi: 10.1001/jamapsychiatry.2016.2594.

2. Nörby U, Forsberg L, Wide K, et al. Neonatal morbidity after maternal use of antidepressant drugs during pregnancy. Pediatrics. 2016;138(5). doi: 10.1542/peds.2016-0181.

3. Boukhris T, Sheehy O, Mottron L, Bérard A. Antidepressant use during pregnancy and the risk of autism spectrum disorder in children. JAMA Pediatr. 2016;170(2):117-124. doi: 10.1001/jamapediatrics.2015.3356.

4. Kantor ED, Rehm CD, Haas JS, Chan AT, Giovannucci EL. Trends in prescription drug use among adults in the United States from 1999-2012. JAMA. 2015;314(17): 1818-1831. doi: 10.1001/jama.2015.13766.