Original Investigation

Psychopharmacology

, Volume 217, Issue 2, pp 211-219

Length of prenatal exposure to selective serotonin reuptake inhibitor (SSRI) antidepressants: effects on neonatal adaptation and psychomotor development

  • Regina C. CasperAffiliated withDepartment of Psychiatry and Behavioral Sciences, Stanford University School of Medicine Email author 
  • , Allyson A. GillesAffiliated withDepartment of Psychiatry and Behavioral Sciences, Stanford University School of Medicine
  • , Barry E. FleisherAffiliated withDivision of Neonatology and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine
  • , Joan BaranAffiliated withDivision of Neonatology and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine
  • , Gregory EnnsAffiliated withDivision of Medical Genetics, Department of Pediatrics, Stanford University School of Medicine
  • , Laura C. LazzeroniAffiliated withDepartment of Psychiatry and Behavioral Sciences, Stanford University School of MedicineDepartment of Pediatrics, Stanford University School of Medicine

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Abstract

Objectives

This study evaluated the question whether length of in utero exposure to selective serotonin reuptake inhibitor (SSRI) antidepressants might affect neonatal outcome and psychomotor development in infancy.

Methods

Birth outcome was determined in the offspring of 55 women with major depressive disorder who used SSRI medication for different durations during their pregnancies. At an average age of 14 months, children underwent a pediatric examination and an evaluation with the Bayley Scales of Infant Development (BSID-II).

Results

Duration of in utero exposure to SSRIs was negatively associated with total Apgar scores, specifically the activity subscale. Odds ratios for a low score (<2) on this scale were 3.8 and 6.0 at 1 and 5 min, respectively. Newborns with longer exposure were more often admitted to the Neonatal Intensive Care Unit (p < .03). Mental Development Index scores of the infants were not associated with the length of gestational exposure to SSRIs. A longer duration of exposure increased the risk for lower Psychomotor Developmental Index and Behavioral Rating Scale scores in infancy (p = 0.012 and p = 0.007, respectively) on the BSID-II.

Conclusions

The findings provide evidence that the length of prenatal SSRI antidepressant use can affect neonatal adjustment and can have an effect on psychomotor test scores in infancy. Importantly, the children’s mental development and motor function by neurological examination were within the normal range. Timing of exposure to SSRIs during susceptible periods of fetal development and variations in the severity of maternal depression may have contributed to the associations.

Keywords

SSRI antidepressants Duration of fetal exposure Apgar scores Mental and psychomotor development