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. Casper
  • Allyson A. Gilles
  • Barry E. Fleisher
  • Joan Baran
  • Gregory Enns
  • Laura C. Lazzeroni
Original Investigation

DOI: 10.1007/s00213-011-2270-z

Cite this article as:
Casper, R.C., Gilles, A.A., Fleisher, B.E. et al. Psychopharmacology (2011) 217: 211. doi:10.1007/s00213-011-2270-z

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 antidepressantsDuration of fetal exposureApgar scoresMental and psychomotor development

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Regina C. Casper
    • 1
  • Allyson A. Gilles
    • 1
  • Barry E. Fleisher
    • 2
  • Joan Baran
    • 2
  • Gregory Enns
    • 3
  • Laura C. Lazzeroni
    • 1
    • 4
  1. 1.Department of Psychiatry and Behavioral SciencesStanford University School of MedicineStanfordUSA
  2. 2.Division of Neonatology and Developmental Medicine, Department of PediatricsStanford University School of MedicineStanfordUSA
  3. 3.Division of Medical Genetics, Department of PediatricsStanford University School of MedicineStanfordUSA
  4. 4.Department of PediatricsStanford University School of MedicineStanfordUSA