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Articles   |    
Does Fetal Exposure to SSRIs or Maternal Depression Impact Infant Growth?
Katherine L. Wisner, M.D., M.S.; Debra L. Bogen, M.D.; Dorothy Sit, M.D.; Mary McShea, M.A.; Carolyn Hughes, M.S.W.; David Rizzo, M.S.W.; Andrea Confer, B.S.; James Luther, M.A.; Heather Eng, B.A.; Stephen W. Wisniewski, Ph.D.
Am J Psychiatry 2013;170:485-493. doi:10.1176/appi.ajp.2012.11121873
View Author and Article Information

Dr. Sit reports donations of light boxes from Uplift Technologies for a K23 study on light therapy for bipolar depression; NIMH Career Development Award K23 MH-082114; and funding through the Clinical and Translational Science Institute, Montefiore Hospital, University of Pittsburgh (NIH/NCRR/CTSA grant UL1 RR-024153) for lab collection related to light study. Dr. Wisniewski reports advisory panel consulting for Cyberonic (2005–2009), ImaRx Therapeutics (2006), Bristol-Myers Squibb (2007–2008), Organon (2007), Case-Western University (2007), Singapore Clinical Research Institute (2009), Dey Pharmaceuticals (2010), and Venebio (2010). The other authors report no financial relationships with commercial interests.

Supported by NIMH grant R01 MH-60335.

From the Department of Psychiatry, University of Pittsburgh; and the Department of Psychiatry, Case Western Reserve University, Cleveland.

Address correspondence to Dr. Wisner (katherine.wisner@northwestern.edu).

Copyright © 2013 by the American Psychiatric Association

Received December 27, 2011; Revised November 05, 2012; Accepted December 04, 2012.

An erratum to this article has been published | view the erratum
Abstract

Objective  The aim of this study was to compare the growth of infants born to women with antenatal major depressive disorder, either untreated or treated with selective serotonin reuptake inhibitor (SSRI) antidepressants, and infants born to a nondepressed, nonmedicated comparison group across the first year of life.

Method  In this prospective observational study, pregnant women were evaluated at weeks 20, 30, and 36 of gestation, and mother and infant pairs were assessed at 2, 12, 26, and 52 weeks postpartum. Three nonoverlapping groups of women were defined according to their pregnancy exposures: 1) no SSRI and no depression (N=97), 2) SSRI (N=46), and 3) major depression without SSRI (N=31). Maternal demographic and clinical characteristics and newborn outcomes were compared across exposure groups. Infant weight, length, and head circumference were measured by a physician or physician’s assistant who was blind to depression and SSRI exposure status at each postpartum time point.

Results  Both adjusted and unadjusted analyses revealed neither antenatal major depression nor SSRI exposure was significantly associated with infant weight, length, or head circumference relative to nonexposure to either. In addition, the interaction of group and prepregnancy body mass index was also evaluated, and no significant synergistic effect was identified. Similarly, no differential effect of group over time was observed for weight, length, or head circumference.

Conclusions  In utero exposure to major depression or SSRI antidepressants did not affect infant growth with respect to weight, length, or head circumference from birth through 12 months of age.

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FIGURE 1. Physical Measurements Over 1 Year for Infants of Women Exposed to SSRI Antidepressants, Major Depressive Disorder Without SSRIs, or Neither During Pregnancy

FIGURE 2. Physical Measurement Percentilesa Over 1 Year for Infants of Women Exposed to SSRI Antidepressants, Major Depressive Disorder Without SSRIs, or Neither During Pregnancy

a Percentiles based on population statistics from the Centers for Disease Control and Prevention (www.cdc.gov/growthcharts/clinical_charts.htm).

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TABLE 1.Demographic and Clinical Measures for Women Exposed to SSRI Antidepressants, Major Depressive Disorder Without SSRIs, or Neither During Pregnancy
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a Continuous variables were analyzed with analyses of variance. Categorical variables were analyzed with chi-square tests.

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b Significant after Bonferroni correction.

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c Includes infant in current study.

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d SIGH-ADS: Structured Interview Guide for the Hamilton Depression Rating Scale With Atypical Depression Supplement. Baseline scores were determined at or before week 20 of pregnancy.

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e Data were missing for one woman in the SSRI group.

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TABLE 2.Demographic and Clinical Measures for Infants of Women Exposed to SSRI Antidepressants, Major Depressive Disorder Without SSRIs, or Neither During Pregnancy
Table Footer Note

a Continuous variables were analyzed with analyses of variance. Categorical variables were analyzed with chi-square tests.

Table Footer Note

b Significant after Bonferroni correction.

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