Prenatal treatment for depression does not increase the children’s risk of problems with behaviour or IQ through age six, according to research published today in American Journal of Psychiatry.
Research led by Dr. Irena Nulman of The Hospital for Sick Children (SickKids) compared behaviour and IQ of four groups of children to age six years and eleven months, based on their mothers’ prenatal medical profile. The four groups were: no maternal depression, untreated maternal depression, maternal depression treated with SSRIs (selective serotonin reuptake inhibitors), and maternal depression treated with venlafaxine. This is the first such study of its kind.
Dr. Nulman is associate director of the Motherisk Program at SickKids and a professor of paediatrics at University of Toronto. She specializes in how prenatal exposure to medications and toxins affects children’s neurocognitive development.
Treatment does not increase risk
“This answers a question that women who are diagnosed with depression often ask: ‘Is it safe for me to take antidepressants during pregnancy?’ ” says Dr. Nulman. “Health care professionals can reassure women that treatment with SSRIs or venlafaxine does not pose additional risk to the unborn child’s future mental health or IQ. This will give women confidence that treating depression during pregnancy is the best choice for both mother and child,” she says.
Similarly, the length of prenatal treatment did not make any difference in the child’s later behaviour or IQ, Dr. Nulman adds. “Our outcomes show that there is no rationale for women
to stop taking antidepressants part-way through pregnancy,” she says.
In fact, maternal depression is itself an important risk factor for post-natal depression after childbirth, which “can have tragic consequences for the woman, her baby, and her family if it is not treated.”
The women in all four groups entered the study through their calls to Motherisk, a SickKids’ information and educational service for pregnant women and their health professionals.
An additional finding shows that the children of women who were depressed during pregnancy were at moderately elevated risk of behavioural problems through age six compared to children of healthy mothers, regardless of whether the mothers with depression had been treated during pregnancy or not.
“It’s important to understand that this moderate risk is associated with the depression itself, not with treatment,” says Dr. Nulman.
Predictors of IQ
The study is the first to compare IQ of children of mothers who were untreated, treated (with the two medication classes), or healthy. The predictors for IQ in all groups were the child’s sex and the mother’s IQ. “This aligns with IQ predictors in the general population,” says Dr. Nulman.
The next phase of research could compare behaviour and IQ between two siblings of depressed mothers who took medication in one pregnancy and not in the other, Dr. Nulman adds.
Funding for this research was provided by SickKids Foundation and Wyeth-Ayerst Canada.
About The Hospital for Sick Children
The Hospital for Sick Children (SickKids) is recognized as one of the world’s foremost paediatric health-care institutions and is Canada’s leading centre dedicated to advancing children’s health through the integration of patient care, research and education. Founded in 1875 and affiliated with the University of Toronto, SickKids is one of Canada’s most research-intensive hospitals and has generated discoveries that have helped children globally. Its mission is to provide the best in complex and specialized family-centred care; pioneer scientific and clinical advancements; share expertise; foster an academic environment that nurtures health-care professionals; and champion an accessible, comprehensive and sustainable child health system. SickKids is proud of its vision of Healthier Children. A Better World.™ For more information, please visit www.sickkids.ca.
About SickKids Centre for Research and Learning
The SickKids Centre for Research and Learning will bring together researchers from different scientific disciplines and a variety of clinical perspectives, to accelerate discoveries, new knowledge and their application to child health — a different concept from traditional research building designs. The facility will physically connect SickKids science, discovery and learning activities to its clinical operations. Designed by award-winning architects Diamond + Schmitt Inc. and HDR Inc. with a goal to achieve LEED® Gold Certification for sustainable design, the Centre will create an architectural landmark as the eastern gateway to Toronto’s Discovery District. The SickKids Centre for Research and Learning is funded by a grant from the Canada Foundation for Innovation, the Government of Ontario, philanthropist Peter Gilgan and community support for the ongoing fundraising campaign. For more information, please visit www.sickkidsfoundation.com/bepartofit.
For more information, please contact:
The Hospital for Sick Children
Phone: 416-813-7654 ext. 2059
The Hospital for Sick Children