Study shows a link but can't prove cause and effect, and experts stress that overall risk is small
WEDNESDAY, Oct. 12, 2016 (HealthDay News) — Children whose mothers used an often-prescribed type of antidepressant during pregnancy may be more likely to develop speech and language disorders, a new study suggests.
Researchers found that mothers who bought selective serotonin reuptake inhibitor (SSRI) drugs at least twice during pregnancy were 37 percent more likely to have a child with a speech and/or language disorder than those who did not take the antidepressants.
SSRIs include medicines such as Celexa, Lexapro, Paxil, Prozac and Zoloft.
The study was observational, meaning it couldn't prove that the drugs helped cause the language/speech problems, only that there was an association. And experts who reviewed the findings stressed that women who require an SSRI during their pregnancy may still want to stick with the drug.
"It must be remembered that the prevalence of speech-language disorders was very low in all of the offspring studied—including those infants exposed to SSRIs prenatally," said Dr. Andrew Adesman. He's chief of child, developmental & behavioral pediatrics at Cohen Children's Medical Center in New Hyde Park, N.Y.
According to Adesman, "even if follow-up studies confirm that use of SSRIs during pregnancy modestly increase the risk of these offspring having a speech-language disorder, it is important to note that depression—if untreated during pregnancy—also poses significant risks to the mother."
The new study was led by Dr. Alan Brown, professor of epidemiology and psychiatry at Columbia University Medical Center in New York City. His team tracked data on more than 845,000 births in Finland between 1996 and 2010. The children were followed to age 3.
The study found that mothers who bought SSRI drugs at least twice during their pregnancy were 37 percent more likely to have a child with a speech and/or language disorder than those who did not take the antidepressants.
There was no link between SSRI use in pregnancy and the risk of either motor (movement) disorders or academic performance in children.
SSRIs are increasingly used during pregnancy to treat depression and other psychiatric disorders, the study authors noted, but they can cross the placenta and reach the fetus.
"To our knowledge, this is the first study to examine the relationship between maternal antidepressant use and speech/language, scholastic, and motor disorders in offspring," Brown said in a Columbia news release.
He stressed that a cause-and-effect relationship could not be proven, and other factors might explain the observed link.
For example, "the severity of maternal depression cannot be ruled out as an explanation for the increased childhood speech and language disorders" in children whose mothers took an SSRI, Brown said.
Adesman agreed that the issue is a complex one, and pregnant women shouldn't immediately stop taking an antidepressant based on these findings.
"Women who are taking SSRIs for depression and who are planning to get pregnant should discuss the risks and benefits of staying on their SSRI medication with their health care provider," Adesman said. He was not involved with the new study.
Dr. Jennifer Wu is an obstetrician/gynecologist at Lenox Hill Hospital in New York City. She agreed with Adesman, saying that "the important thing to remember is that the overall risk of speech and language disorders [for any child] is still very small."
She also stressed that an effective antidepressant is often essential for some women, so any risk to offspring "must be weighed against the risks of untreated depression. Mothers at risk for severe depression and suicide may not be able to stop their SSRIs."
The study was partially funded by the U.S. National Institutes of Health and was published online Oct. 12 in the journal JAMA Psychiatry.
The U.S. Office on Women's Health has more on pregnancy and medicines.