Could Mom-to-Be’s Antidepressants Have an Upside for Baby’s Brain?
MONDAY, May 7, 2018 (HealthDay News) — Children who were exposed to antidepressants in the womb may score higher on certain tests of mental abilities at the age of 12, a small, preliminary study suggests.
Among the 51 kids the researchers analyzed, those whose mothers used antidepressants during pregnancy typically scored higher on tests of "executive function" than kids with no prenatal exposure to the medications.
Executive function refers to a set of mental skills that essentially help you get things done — including focus and attention, self-control and flexible thinking.
The new study is one of the latest to look at whether kids with prenatal exposure to antidepressants — specifically, selective serotonin reuptake inhibitors (SSRIs) — are different from other kids.
SSRIs are the most commonly prescribed antidepressants, and include drugs like fluoxetine (Prozac), paroxetine (Paxil) and sertraline (Zoloft).
Some studies have hinted that when moms-to-be take SSRIs during pregnancy, their children have a slightly higher risk of psychiatric diagnoses — such as autism and attention-deficit/hyperactivity disorder.
Other studies, however, have found no such connections.
The question of whether prenatal SSRI use has any effects on children's development is a critical one, according to Dr. James Murrough. He is director of the mood and anxiety disorders program at Mount Sinai, in New York City.
"Depression is common, it's more common in women, and it's prevalent during women's childbearing years," said Murrough, who was not involved in the new study. "You put all of that together, and depression during pregnancy is a major public health issue."
But, he said, it's also very difficult to disentangle any effects of SSRIs, themselves, on children's brain development.
"How many factors would affect how well a 12-year-old performs on a cognitive task?" Murrough said. The answer is, a lot.
A huge array of genes would be involved, he explained, along with a broad range of environmental factors — including the mom's depression.
While the new findings sound like positive news for kids who were exposed to SSRIs, it's not really clear what to make of them. For one, Murrough said, the study is too small to draw firm conclusions.
The study researchers agreed.
Children in the study performed a series of computerized tasks that target executive function. And those exposed to SSRIs in the womb scored a bit higher, in general.
But children's scores on those "highly structured" tasks do not necessarily reflect their mental skills in daily life, explained researcher Sarah Hutchison, of British Columbia Children's Hospital, in Vancouver, Canada.
The researchers are continuing to follow a larger group of 120 children, and parents' reports on their kids' thinking skills will be examined, too, according to Hutchison.
She presented the findings Sunday at the Pediatric Academic Societies meeting, in Toronto. Research presented at meetings is considered preliminary until published in a peer-reviewed journal.
Between 15 percent and 20 percent of women will have a "clinically significant" mood disorder during pregnancy, said senior researcher Dr. Tim Oberlander.
Like Murrough, he said that understanding how these women and their children fare is critical, and complicated.
Because brain development is so complex, Oberlander explained, there is no "simple cause-and-effect" relationship between prenatal antidepressant exposure and children's long-term outcomes.
This study does not address the question of whether SSRIs are "safe" for pregnant women, Oberlander added.
For any one woman, he said, the decision on how to treat depression during pregnancy is a personal one.
Oberlander stressed that women should discuss all of the options with their health care provider.
And, he said, everyone from providers to family members should consider ways to help women support their mental health during pregnancy. Stress reduction, regular exercise and adequate sleep are a few key steps.
What is clear, Murrough said, is that depression during pregnancy needs treatment — whether that means antidepressants, "talk therapy" or other options.
Untreated depression has risks for mothers and babies, he explained.
Depression can make it harder for moms-to-be to take care of themselves, or to bond with their newborn, Murrough noted. And some studies have linked untreated depression to higher risks of premature delivery and low birth weight, according to the March of Dimes.
Murrough suggested that if a woman is being treated for depression and might become pregnant, she should talk to her doctor about any therapy adjustments that could be appropriate. Women who are already taking an antidepressant, he said, should not simply stop the drug on their own.
The March of Dimes has more on depression during pregnancy.