title: Internalizing behaviors in 4-year-old children exposed in utero to psychotropic medications.
abstract: OBJECTIVE
  Internalizing behaviors in children between 4 and 5 years of age who had been prenatally exposed to psychotropic medications were investigated. The authors had previously reported the effects of prenatal medication exposure in this same cohort when they were newborns and infants at 3 and 8 months of age.
  
  
  METHODS
  Parental/teacher reports and a clinical measure of mother and child interactions were used to assess levels of internalizing behaviors (e.g., depression, anxiety, withdrawal). Outcomes were compared between children with prenatal selective serotonin reuptake inhibitor (SSRI) exposure (N=22) and nonexposed children of healthy, nondepressed, nonmedicated mothers (N=14). Measures of maternal mood were obtained. Ordered logistic regressions, independent-sample t tests, and univariate ANOVAs were used to compare outcomes between groups. Pearson correlations were used to determine associations between maternal mood and child behaviors.
  
  
  RESULTS
  Levels of internalizing behaviors did not differ significantly between children with prenatal psychotropic medication exposure and those not exposed. However, as symptoms of maternal anxiety and depression increased, so did reported internalizing behaviors in their children.
  
  
  CONCLUSIONS
  Prenatal exposure to psychotropic medications was not associated with increased reports of internalizing behaviors at 4 years of age, whereas impaired maternal mood did have an identified impact on child behavior. Further study of complex associations between maternal psychiatric disorders, prenatal SSRI exposure, and childhood internalizing behaviors is required to understand if the child outcome is affected by the illness, medications, or a combination of both.
authors.affiliation: Reproductive Mental Health Program, St. Paul's Hospital, Rm. 2B-185, 1081 Burrard St., Vancouver, BC V6Z 1Y6, Canada. smisri@providencehealth.bc.ca
authors.forename: Shaila
authors.initials: S
authors.lastname: Misri
authors.forename: Pratibha
authors.initials: P
authors.lastname: Reebye
authors.forename: Kristin
authors.initials: K
authors.lastname: Kendrick
authors.forename: Diana
authors.initials: D
authors.lastname: Carter
authors.forename: Deirdre
authors.initials: D
authors.lastname: Ryan
authors.forename: Ruth E
authors.initials: RE
authors.lastname: Grunau
authors.forename: Tim F
authors.initials: TF
authors.lastname: Oberlander
mesh_terms: D000328:Adult; D000339:Affect; D000367:Age Factors; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology; D002653:Child Behavior Disorders / Q000139:chemically induced* / Q000453:epidemiology; D016241:Child of Impaired Parents; D002675:Child, Preschool; D015331:Cohort Studies; D003866:Depressive Disorder / Q000188:drug therapy* / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006801:Humans; D016015:Logistic Models; D018811:Maternal Exposure; D008431:Maternal-Fetal Exchange; D009034:Mother-Child Relations; D009035:Mothers / Q000523:psychology; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D011619:Psychotropic Drugs / Q000009:adverse effects* / Q000627:therapeutic use; D015203:Reproducibility of Results
chemical_list: D011619:Psychotropic Drugs