Prenatal Selective Serotonin Reuptake Inhibitor Exposure, Depression, and Brain Morphology in Middle Childhood: Results From the ABCD Study

Moreau, Allison L.; Voss, Michaela; Hansen, Isabella; Paul, Sarah E.; Barch, Deanna M.; Rogers, Cynthia; Bogdan, Ryan

doi:10.1016/j.bpsgos.2022.02.005

Cited by 8 publications

(10 citation statements)

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“…In the Generation R Study, for example, women receiving SSRIs had lower income and more depressive symptoms and benzodiazepine use in pregnancy, suggesting a more severe and comorbid phenotype. In the aforementioned ABCD Study, SSRI use similarly varied by race and income . Some differences may be adjustable through techniques such as inverse-probability weighting, but we can only correct for what we measure, and residual confounding likely persisted.…”

Section: A Breakthrough Study With Long-term Follow-up and Longitudin...mentioning

confidence: 99%

“…Without that next piece, it would be premature to draw clinical conclusions from this study alone. Another recently published study by Moreau et al, which used data from the Adolescent Brain Cognitive Development Study (ABCD) cohort in the US, reported that SSRI-exposed children had a larger left parietal surface area and thicker occipital cortex. Effect sizes were small and showed no associations with childhood symptoms, although it should be noted that the children were only 9 to 10 years of age.…”

Section: A Breakthrough Study With Long-term Follow-up and Longitudin...mentioning

confidence: 99%

“…A broader scan of the literature highlights a persistent issue in this line of research—that women who take SSRIs during pregnancy frequently reflect a different clinical and/or sociodemographic distribution than those who have depression but do not take SSRIs . In the Generation R Study, for example, women receiving SSRIs had lower income and more depressive symptoms and benzodiazepine use in pregnancy, suggesting a more severe and comorbid phenotype.…”

Section: A Breakthrough Study With Long-term Follow-up and Longitudin...mentioning

confidence: 99%

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Maternal Depression, Prenatal SSRI Exposure, and Brain Trajectories in Childhood

Talati

2023

JAMA Psychiatry

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Section: A Breakthrough Study With Long-term Follow-up and Longitudin...mentioning

confidence: 99%

Section: A Breakthrough Study With Long-term Follow-up and Longitudin...mentioning

confidence: 99%

Section: A Breakthrough Study With Long-term Follow-up and Longitudin...mentioning

confidence: 99%

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Maternal Depression, Prenatal SSRI Exposure, and Brain Trajectories in Childhood

Talati

2023

JAMA Psychiatry

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“…Previously, our research group showed that prenatal SSRI exposure was associated with reduced fetal head growth assessed by ultrasonography . To our knowledge, only 3 structural magnetic resonance imaging (MRI) studies have examined prenatal SSRI exposure and brain volume in humans, of which 2 were retrospective studies in neonates . SSRI-exposed newborns had larger amygdala and superior frontal cortices .…”

Section: Introductionmentioning

confidence: 99%

“…However, these 2 studies had small samples (14-16 infants) . The third study showed that prenatal SSRI exposure (n = 235) was associated with a larger surface area in the left superior parietal cortex and a thicker left lateral occipital cortex in children aged 9 to 10 years . However, the study was based on retrospective maternal reports of SSRI use and depressive symptoms during pregnancy, which could be prone to recall bias.…”

Section: Introductionmentioning

confidence: 99%

Prenatal Antidepressant Exposure and Offspring Brain Morphologic Trajectory

Koc,

Tiemeier,

Stricker

et al. 2023

JAMA Psychiatry

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ImportanceClinical decision-making on antidepressant treatment during pregnancy, particularly selective serotonin reuptake inhibitors (SSRIs), is challenging, as both prenatal SSRI exposure and maternal depressive symptoms may be associated with negative outcomes in offspring.ObjectiveTo investigate the association between intrauterine SSRI exposure and maternal depressive symptoms and structural brain development in offspring from mid-childhood to early puberty.Design, Setting, and ParticipantsThis prospective, population-based cohort study was embedded in the Generation R Study in Rotterdam, the Netherlands. All pregnant individuals with an expected delivery date between April 1, 2002, and January 31, 2006, were invited to participate. Data were analyzed from February 1 to September 30, 2022.ExposureMaternal-reported SSRI use verified by pharmacy records. In mid-pregnancy and 2 and 6 months after delivery, participants reported depressive symptoms using the Brief Symptom Inventory and were divided into 5 groups: SSRI use during pregnancy (n = 41; 80 scans), SSRI use only before pregnancy (n = 77; 126 scans), prenatal depressive symptoms without prenatal SSRI use (n = 257; 477 scans), postnatal depressive symptoms only (n = 74; 128 scans), and nonexposed control individuals (n = 2749; 4813 scans).Main Outcomes and MeasuresThe main outcome was brain morphometry in offspring, including global and cortical brain volumes, measured at 3 magnetic resonance imaging assessments from 7 to 15 years of age.ResultsThe study included 3198 mother-child dyads. A total of 3198 mothers (100%) identified as women; mean (SD) age at intake was 31.1 (4.7) years. Children (1670 [52.2%] female) underwent brain imaging assessment from 7 to 15 years of age with 5624 total scans. Most brain gray matter volumes showed an inverted U–shaped trajectory. Compared with nonexposed controls, children prenatally exposed to SSRIs had less cerebral gray matter (β [SE], −20 212.2 [7285.6] mm3; P = .006), particularly within the corticolimbic circuit, which persisted up to 15 years of age. Children exposed to SSRIs prenatally showed a steeper increase in volumes of the amygdala (age interaction: β [SE], 43.3 [13.4] mm3; P = .006) and fusiform gyrus (age interaction: β [SE], 168.3 [51.4] mm3; P = .003) from 7 to 15 years of age. These volumetric differences in the amygdala and fusiform observed in childhood did not persist until early adolescence. Prenatal depression was associated with a smaller volume in the rostral anterior cingulate gyrus (β [SE], −166.3 [65.1] mm3; P = .006), and postnatal depression was associated with a reduced fusiform gyrus (β [SE], −480.5 [189.2] mm3; P = .002). No association of SSRI use before pregnancy with brain outcomes was observed.Conclusions and RelevanceThe results of this cohort study suggest that prenatal SSRI exposure may be associated with altered developmental trajectories of brain regions involved in emotional regulation in offspring. Further research on the functional implications of these findings is needed.

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Social determinants of antidepressant continuation during pregnancy in the USA: findings from the ABCD cohort study

Dupuis,

Weir,

Vidonscky Lüthold

et al. 2024

Arch Womens Ment Health

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Purpose Patients and healthcare professionals overestimate the risks of using antidepressants during pregnancy. According to current literature, approximately half of people stop taking an anti-depressant medication when they become pregnant. Discontinuing antidepressants during pregnancy increases risks of postnatal relapses. Factors like socioeconomic status, education, and planned pregnancies play a role in the decision to continue antidepressant medication, which can worsen disparities in maternal and child health. Our aim was to identify the sociodemographic factors associated with antidepressant continuation after awareness of pregnancy. Methods We used representative data from the Adolescent Brain Cognitive Development (ABCD) study that captures maternal medication during pregnancy. We identified women who used antidepressants before awareness of their pregnancy. We calculated crude and adjusted associations between sociodemographic factors and continuation of antidepressant medication during pregnancy. Our model included age, education, ethnicity, first language, household income, living with a partner, having planned the pregnancy, pregnancy duration and smoking during pregnancy. Results In total, 199 women continued antidepressants and 100 discontinued. The logistic regressions resulted in only one significant factor: first language. Native English speakers were more likely to continue medication than other mothers (adjusted OR = 14.94, 95% CI = [2.40; 291.45], p = .015). Conclusions Language differences were associated with continuation of antidepressants. Non-native English speakers were more likely to discontinue antidepressants, which may lead to health inequities. This finding should be taken into account to reinforce information about the limited risks of antidepressants among people with non-English speaking backgrounds in the USA.

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Prenatal Selective Serotonin Reuptake Inhibitor Exposure, Depression, and Brain Morphology in Middle Childhood: Results From the ABCD Study

Cited by 8 publications

References 57 publications

Maternal Depression, Prenatal SSRI Exposure, and Brain Trajectories in Childhood

Maternal Depression, Prenatal SSRI Exposure, and Brain Trajectories in Childhood

Prenatal Antidepressant Exposure and Offspring Brain Morphologic Trajectory

Social determinants of antidepressant continuation during pregnancy in the USA: findings from the ABCD cohort study

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