Prenatal effects of selective serotonin reuptake inhibitor antidepressants, serotonin transporter promoter genotype (SLC6A4), and maternal mood on child behavior at 3 years of age.
OBJECTIVE
To investigate whether prenatal selective serotonin reuptake inhibitor (SSRI) antidepressant exposure affects behavior in 3-year-olds of antenatally anxious or depressed mothers and whether risk was moderated by the serotonin transporter promoter (SLC6A4) genotype.


METHODS
Prospective longitudinal cohort design.


METHODS
Vancouver.


METHODS
Mothers and their 3-year-old children (n = 33 SSRI exposed and n = 42 nonexposed). Main Exposures Prenatal exposure to SSRI antidepressants and prenatal and postnatal maternal mood disturbances.


METHODS
Parent report of child behavior (Child Behavior Checklist, ages 1.5-5 years) and the child SLC6A4 genotype. The covariates used were maternal mood during the third trimester, 3 months postpartum, and at the 3-year follow-up study and the child's 5-minute Apgar score.


RESULTS
Prenatal exposure to both maternal depressed mood and SSRI antidepressants were associated with increased internalizing behaviors during early childhood, whereas current maternal mood increased risk for externalizing behaviors. Increased child anxiety and depression symptoms were predicted by higher third-trimester maternal anxiety only in children with 2 short S alleles. In contrast, increased aggression and externalizing behaviors were predicted by third-trimester maternal anxiety only in children with 2 copies of the L allele.


CONCLUSIONS
Exposure to prenatal SSRIs and maternal mood had distinct effects on child behavior at 3 years of age, reflected in an increased level of internalizing behaviors. The impact of antenatal maternal anxiety on child mood was moderated by the child SLC6A4 genotype. Despite SSRI treatment for prenatal maternal mood disturbances, childhood behavior at 3 years of age remained at risk.
Oberlander
Tim F
TF
Early Human Experience Unit, Developmental Neurosciences and Child Health, and Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada.
Papsdorf
Michael
M
Brain
Ursula M
UM
Misri
Shaila
S
Ross
Colin
C
Grunau
Ruth E
RE
D000328:Adult; D001034:Apgar Score; D002652:Child Behavior / Q000187:drug effects*; D002675:Child, Preschool; D005260:Female; D005838:Genotype; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D018811:Maternal Exposure / Q000009:adverse effects*; D019964:Mood Disorders / Q000188:drug therapy* / Q000235:genetics / Q000523:psychology*; D009035:Mothers / Q000523:psychology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy* / Q000523:psychology*; D011263:Pregnancy Trimester, Third; D011297:Prenatal Exposure Delayed Effects; D011446:Prospective Studies; D050486:Serotonin Plasma Membrane Transport Proteins / Q000235:genetics*; D017367:Selective Serotonin Reuptake Inhibitors / Q000494:pharmacology*
D050486:Serotonin Plasma Membrane Transport Proteins; D017367:Selective Serotonin Reuptake Inhibitors; C493230:SLC6A4 protein, human