New York—When expectant mothers had depression-related psychiatric disorders, and especially when they purchased selective serotonin reuptake inhibitors (SSRIs) at least twice during their pregnancies, their offspring had an increased risk for speech/language disorders.

That’s according to a report in JAMA Psychiatry, which cautions that further studies are needed before conclusions can be drawn about possible clinical implications. Background information in the article notes that the use of SSRIs, which can cross the placenta and enter the fetal circulation, is increasing.

A study team led by researchers from the Columbia University College of Physicians and Surgeons and the Mailman School of Public Health used register data in Finland from 1996 to 2010 to examine exposure to SSRIs during pregnancy and the risk of speech/language, scholastic, and motor disorders in children up to early adolescence.

The final study group included 56,340 infants, about 51% male, and was divided into three groups:

• 15,596 were in the SSRI-exposed group because their mothers were diagnosed as having depression-related psychiatric disorders with a history of purchasing SSRIs during pregnancy.

• 9,537 were in the unmedicated group because their mothers were diagnosed as having depression-related psychiatric disorders or other psychiatric disorders associated with SSRI use, but had no history of purchasing SSRIs during pregnancy.

• 31,207 were in the unexposed group because they were neither exposed prenatally to an SSRI nor had mothers with a psychiatric diagnosis. 

Children who developed the disorders were diagnosed at an average age of 4.4 years for speech/language disorders, 3.5 years for scholastic disorders and 7.7 years for motor disorders, according to the research. 

Results indicate that the children of mothers who purchased SSRIs at least twice during pregnancy had a 37% increased risk of speech/language disorders compared with offspring in the unmedicated group and a 63% increased risk compared with children in the unexposed group.

Overall, the risk of speech/language disorders was increased among the children of mothers who used SSRIs during pregnancy, as well as the children of mothers diagnosed as having depression or other psychiatric disorders who did not take SSRIs, compared with children in the group who had mothers with no psychiatric diagnoses or SSRI use.

Study authors emphasize that the study is observational and, therefore, causality cannot be inferred. The authors also cannot confirm from population registries that the purchased SSRIs were actually taken. 

“We found a significant increase in the risk of speech/language disorders among offspring of mothers who purchased SSRIs at least twice during pregnancy compared with mothers diagnosed as having depression or other psychiatric disorders not treated with antidepressants,” researchers conclude. “Further studies are necessary to replicate these findings and to address the possibility of confounding by additional covariates before conclusions regarding the clinical implications of the results can be drawn.”

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