Long-Term Effects of Intrauterine Exposure to Antidepressants on Physical, Neurodevelopmental, and Psychiatric Outcomes: A Systematic Review.
Antidepressive Agents
/ adverse effects
Child
Child Development
/ drug effects
Child, Preschool
Female
Humans
Mental Disorders
/ chemically induced
Neurodevelopmental Disorders
/ chemically induced
Pregnancy
Pregnancy Complications
/ drug therapy
Prenatal Exposure Delayed Effects
/ chemically induced
Journal
The Journal of clinical psychiatry
ISSN: 1555-2101
Titre abrégé: J Clin Psychiatry
Pays: United States
ID NLM: 7801243
Informations de publication
Date de publication:
12 05 2020
12 05 2020
Historique:
received:
21
06
2019
accepted:
25
10
2019
entrez:
16
5
2020
pubmed:
16
5
2020
medline:
15
9
2020
Statut:
epublish
Résumé
Reviews on child outcomes following in utero antidepressant exposure have focused on short-term outcomes. However, several recent individual studies reported on adverse physical, neurodevelopmental, and psychiatric outcomes beyond infancy and early childhood. The objective of this systematic review was to establish the long-term effects of prenatal antidepressant exposure on physical, neurodevelopmental, and psychiatric outcomes in individuals aged 4 years and older. Embase, MEDLINE Ovid, Web of Science, Cochrane Central, and Google Scholar were systematically searched for all relevant articles, written in English and published prior to November 8, 2018, using terms describing antidepressants, pregnancy, and developmental outcomes. All original research articles on long-term outcomes of prenatal antidepressant exposure were eligible for inclusion. After screening and removal of duplicates, a total of 34 studies were identified. Included articles were qualitatively analyzed to determine inconsistency, indirectness, imprecision, and study bias. The identified studies demonstrated statistically significant associations between prenatal antidepressant exposure and a range of physical, neurodevelopmental, and psychiatric outcomes. Yet, the risk of confounding by indication was high. When controlling for confounders, 5 studies investigating physical outcomes (asthma, cancer, body mass index [BMI], epilepsy) found no association except conflicting outcomes for BMI. Eighteen studies examining neurodevelopmental outcomes (cognition, behavior, IQ, motor development, speech, language, and scholastic outcomes) found no consistent associations with antidepressant exposure after taking confounders into account. Eleven studies investigated psychiatric outcomes. After adjusting for confounders, prenatal antidepressant exposure was associated with affective disorders but not with childhood psychiatric outcomes (eg, autism spectrum disorders, attention-deficit/hyperactivity disorder). Reported associations between in utero exposure to antidepressants and physical, neurodevelopmental, and psychiatric outcomes, in large part, seem to be driven by the underlying maternal disorder. When limiting confounding by indication, prenatal exposure to antidepressants was significantly associated only with offspring BMI and affective disorders.
Identifiants
pubmed: 32412703
doi: 10.4088/JCP.19r12965
pmc: PMC8739257
mid: NIHMS1765434
doi:
pii:
Substances chimiques
Antidepressive Agents
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : NIMH NIH HHS
ID : R01 MH122869
Pays : United States
Commentaires et corrections
Type : CommentIn
Informations de copyright
© Copyright 2020 Physicians Postgraduate Press, Inc.
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