Maternal antidepressant prescriptions and developmental "vulnerabilities"

  • Singal D & al.
  • Pediatrics
  • 27/04/2020

  • Susan London
  • Clinical Essentials
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Takeaway

  • School readiness scores suggest that developmental "vulnerability" might be modestly more common among kindergartners born to mothers who had mood or anxiety disorders and were dispensed antidepressants during pregnancy.

Why this matters

  • Editorial: notes several confounders not included in the analysis and that the index used measures school readiness and has "only modest specificity for developmental vulnerability and is not strongly correlated with language development."

Key results

  • Exposed vs unexposed kindergartners more likely to be vulnerable:
    • In ≥2 neurodevelopmental domains:
      • 21.43% vs 16.16%;
      • aOR, 1.43 (95% CI, 1.08-1.90).
    • In language and cognition domain:
      • 12.94% vs 12.4%;
      • aOR, 1.40 (95% CI, 1.03-1.90).
  • The 2 groups were statistically indistinguishable regarding vulnerability in:
    • ≥1 neurodevelopmental domain,
    • Physical well-being,
    • Communication/general knowledge,
    • Social competence domain, and
    • Emotional maturity domain.

Study design

  • Population-based cohort study of children born 1996-2014 in Canada to mothers with a mood or anxiety disorder diagnosis in 90 days before conception.
  • Comparison by maternal antidepressant dispensations during pregnancy:
    • 392 exposed children (≥2 dispensations),
    • 2197 unexposed children (no dispensations).
  • Main outcome: developmental health of offspring in kindergarten (Early Development Instrument, which measures school readiness).
  • Funding: Canadian Institutes of Health Research.

Limitations

  • Possible exposure misclassification.
  • Unmeasured and residual confounding.
  • Limitations of the tool for detecting neurocognitive deficits.