Norwegian Mothers’ Prenatal Selective Serotonin Reuptake Inhibitor (SSRI) Antidepressant Use and Their Children’s Subsequent Functioning

SSRIs are widely used to treat depression, including during pregnancy. Because SSRIs cross the placenta and the blood-brain barrier, questions arise about possible effects on fetal development. To provide more refined tests of previously reported associations between prenatal SSRI exposure and children’s subsequent functioning, Norwegian researchers compared age 1½-, 3-, and 5-year CBCL/1½-5 scores, as well as scores on the Emotionality, Activity, and Shyness Questionnaire (EAS), for children whose mothers had taken SSRIs during prenatal weeks 0-16 (early pregnancy), weeks 17-28 (mid-pregnancy), >week 29 (late pregnancy), or not at all (Lupatelli et al., 2018). Among 79,203 mothers participating in the Norwegian Mother and Child Cohort Study, 8,539 mothers reported having depressive/anxiety disorders before or during pregnancies that ended in live births.

It was found that children of the depressed/anxious mothers who had taken SSRIs late in pregnancy (>week 29) obtained higher scores on the CBCL/1½-5 Anxious/Depressed syndrome than children whose mothers took no SSRIs during pregnancy, starting at age 3 and increasing through age 5 (significant odds ratio = 2.5 at age 5, a medium effect size). No significant effects were found on other CBCL/1½-5 syndromes, Internalizing, Externalizing, nor on EAS scores. The authors concluded that their findings “may provide some insights into potentially important periods of fetal vulnerability to SSRI exposure. This potential risk needs to be balanced against a potentially detrimental effect of untreated maternal depression” (p. 206).

Reference: Lupattelli, A., Wood, M., Ystrom, E., Skurtveit, S., Handal, M., & Nordeng, H. (2018). Effect of time-dependent selective serotonin reuptake inhibitor antidepressants during pregnancy on behavioral, emotional, and social development in preschool-aged children. Journal of the American Academy of Child and Adolescent Psychiatry, 57, 200-208.