Infant neurodevelopment following in utero exposure to antidepressant medication.

AIM: To examine the impact of pregnancy exposure to antidepressants on infant neurodevelopment. METHODS: A prospective, longitudinal study in which antidepressant-exposed (n = 35) and nonexposed (n = 23) infants were administered the Bayley Scales of Infant Development (BSID-III) at 18 months, which measures neurodevelopment across five domains. Data on obstetric and perinatal complications, maternal IQ, presence of mood disorder in pregnancy and up to and including 18 months, and psychosocial status were also collected. RESULTS: Almost 90% of infants were exposed throughout the second and third trimesters to therapeutic antidepressant doses. Bivariate analysis showed no difference between exposed and unexposed infants in any of the neurodevelopmental outcomes. Maternal depression around birth or up to time of developmental testing was not associated with neurodevelopmental outcomes. CONCLUSION: Our results suggest that pregnancy antidepressant exposure (mostly serotonin reuptake inhibitors) is not associated with poorer cognitive, motor or language development outcomes in infants at 18 months. This information supports earlier studies and adds into the available data used by clinicians and mothers making key decisions around the use of antidepressants in pregnancy. However, given the small sample size, and some degree of heterogeneity in terms of antidepressant exposure, these results need to be treated with caution.

Antenatal psychosocial assessment: how accurate are we in determining 'low-risk' status? A pilot study.

Routine Comprehensive Psychosocial Assessment was implemented antenatally at a public hospital in Sydney in 2000. The assessment, completed on all women, classifies them as (1) currently, or at high-risk of becoming, distressed, or, (2) not currently, or at low risk of becoming, distressed during the perinatal period. This pilot study followed up a sample of women (N = 50) from the latter group at 6 weeks postpartum to explore the accuracy of 'low risk' identification. All but one woman reported that they continued to do well during their pregnancy. By 6 weeks postpartum only one woman scored high on the validated depression measure though data from a semi-structured interview indicated that a further four women experienced sub-clinical difficulty in the early weeks postpartum. The antenatal classification of women as 'low risk' using this assessment method appears to be substantially accurate, though this finding needs to be replicated in a larger study.