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 One study suggests newborns are more likely to need intensive care
after birth if their mothers take selective serotonin reuptake
inhibitors (SSRIs) during pregnancy. A second study finds those same
children may be at an increased risk for speech and language
disorders years later.
Links between SSRIs and these types of birth outcomes have been seen
before in previous studies that weren't as reliable, said Dr. Eva
Pressman, chair of obstetrics and gynecology at the University of
Rochester Medical Center in New York.
Even with these associations, she said, women should make decisions
about their SSRI use only after talking with their healthcare
providers about their specific circumstances.
"If you don’t apply the specifics of the situation, you can do more
harm than good by avoiding medication," Pressman, who wasn't
involved with the new studies, told Reuters Health. "Individualized
care becomes exceedingly important."
Ulrika Norby of Lund University in Sweden and colleagues analyzed
data on nearly 750,000 births in that country from 2006 through
2012. About 2 percent of the children had been exposed to SSRIs
while in the womb.
About 14 percent of newborns exposed to SSRIs were admitted to the
neonatal intensive care unit (NICU) after birth, compared to about 8
percent of those not exposed to the drug, according to the results
online October 25th in the journal Pediatrics. The increased risk
was more pronounced when mothers took SSRIs late in pregnancy.
"The vast majority of infants exposed to SSRIs during pregnancy did
not have problems requiring neonatal care," Norby told Reuters
Health in an email. "The risk increase for severe disease is small
in the individual case."
In the second study, researchers analyzed data on more than 56,000
children, most under the age of 9, to see if those who'd been
exposed to SSRIs in the womb were more likely to have cognitive
problems.
The children were born between 1996 and 2010 in Finland. About 28
percent had been exposed to SSRIs during pregnancy. Another 17
percent were born to mothers who had depression but did not purchase
SSRIs during pregnancy. The remaining 55 percent were born to
mothers who didn't take SSRIs and did not have depression.
There were no links between SSRI exposure in the womb and scholastic
or motor disorders in the children, according to Dr. Alan Brown at
Columbia University in New York City and his colleagues, who
included researchers from the University of Turku in Finland.
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But as reported in JAMA Psychiatry October 12th, for children whose
mothers purchased at least two SSRI prescriptions during pregnancy,
the risk of speech and language disorders was 37 percent higher than
it was for children whose mothers had depression but didn't take the
drugs and 63 percent higher than for children whose mothers didn't
have depression.
"There is a possible association between SSRIs during pregnancy and
speech and language delays," Brown told Reuters Health.
In a 2009 joint report, the American College of Obstetricians and
Gynecologists and the American Psychiatric Association said
depression and antidepressant medications during pregnancy are tied
to negative consequences for newborns (http://bit.ly/2eKrZ6H).
The organizations say some women with mild-to-moderate depression
can be treated with psychotherapy alone or with medication. Also,
they say, there is a need for ongoing discussions during pregnancy
between a woman's psychiatrist and her obstetrician.
"Every situation is unique and must be discussed with the physician
responsible for the treatment," Norby said. "It is important not to
discontinue treatment without consulting a health care professional.
Untreated psychiatric conditions can have profound negative
consequences for both the woman and her child."
SOURCE: http://bit.ly/2eRT2ce and http://bit.ly/2eKvk5x
Pediatrics 2016. JAMA Psychiatry 2016.
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