title: Length of prenatal exposure to selective serotonin reuptake inhibitor (SSRI) antidepressants: effects on neonatal adaptation and psychomotor development.
abstract: OBJECTIVE
  This study evaluated the question whether length of in utero exposure to selective serotonin reuptake inhibitor (SSRI) antidepressants might affect neonatal outcome and psychomotor development in infancy.
  
  
  METHODS
  Birth outcome was determined in the offspring of 55 women with major depressive disorder who used SSRI medication for different durations during their pregnancies. At an average age of 14 months, children underwent a pediatric examination and an evaluation with the Bayley Scales of Infant Development (BSID-II).
  
  
  RESULTS
  Duration of in utero exposure to SSRIs was negatively associated with total Apgar scores, specifically the activity subscale. Odds ratios for a low score (<2) on this scale were 3.8 and 6.0 at 1 and 5 min, respectively. Newborns with longer exposure were more often admitted to the Neonatal Intensive Care Unit (p < .03). Mental Development Index scores of the infants were not associated with the length of gestational exposure to SSRIs. A longer duration of exposure increased the risk for lower Psychomotor Developmental Index and Behavioral Rating Scale scores in infancy (p = 0.012 and p = 0.007, respectively) on the BSID-II.
  
  
  CONCLUSIONS
  The findings provide evidence that the length of prenatal SSRI antidepressant use can affect neonatal adjustment and can have an effect on psychomotor test scores in infancy. Importantly, the children's mental development and motor function by neurological examination were within the normal range. Timing of exposure to SSRIs during susceptible periods of fetal development and variations in the severity of maternal depression may have contributed to the associations.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Room 2365, Stanford, CA, 94305-5723, USA. rcasper@stanford.edu
authors.forename: Regina C
authors.initials: RC
authors.lastname: Casper
authors.forename: Allyson A
authors.initials: AA
authors.lastname: Gilles
authors.forename: Barry E
authors.initials: BE
authors.lastname: Fleisher
authors.forename: Joan
authors.initials: J
authors.lastname: Baran
authors.forename: Gregory
authors.initials: G
authors.lastname: Enns
authors.forename: Laura C
authors.initials: LC
authors.lastname: Lazzeroni
mesh_terms: D000223:Adaptation, Psychological / Q000187:drug effects*; D000928:Antidepressive Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D001034:Apgar Score; D002657:Child Development / Q000187:drug effects*; D003865:Major Depressive Disorder / Q000188:drug therapy / Q000523:psychology; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007223:Infant; D018730:Infant Behavior / Q000187:drug effects; D007231:Infant, Newborn; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000139:chemically induced* / Q000523:psychology; D011597:Psychomotor Performance / Q000187:drug effects*; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D013997:Time Factors
chemical_list: D000928:Antidepressive Agents; D017367:Selective Serotonin Reuptake Inhibitors