title: Maternal use of antidepressant or anxiolytic medication during pregnancy and childhood neurodevelopmental outcomes: a systematic review.
abstract: Antidepressant and anxiolytic medications are widely prescribed and used by pregnant women for acute and maintenance therapy. These drugs are able to pass the placental barrier, and may potentially influence fetal and brain development. It is possible that exposure to prenatal antidepressants or anxiolytic medication may disturb neurotransmitter systems in the brain and have long-lasting consequences on neurodevelopment in the offspring. As all medication during pregnancy may pose a certain risk to the developing fetus, the potential benefits of the medication must be weighed against the risks for both mother and her unborn child. Therefore, information to guide patients and physicians to make a well-balanced decision for the appropriate treatment during pregnancy is needed. In this systematic review, an overview of maternal use of antidepressant or anxiolytic medication during pregnancy and childhood neurodevelopmental outcomes is provided. Some studies indicate a relation between prenatal exposure to antidepressants and adverse neurodevelopmental outcomes such as delayed motor development/motor control, social difficulties, internalizing problems and autism, but cannot rule out confounding by indication. Overall, the results of the observational studies have been inconsistent, which makes translation of the findings into clinical recommendations difficult. More well-designed observational studies and also randomized controlled trials (e.g., maintenance treatment vs. cessation) are needed to move forward and provide a comprehensive evaluation of the risks and benefits of antidepressant and anxiolytic use during pregnancy.
authors.affiliation: The Department of Child and Adolescent Psychiatry, Erasmus MC, Sophia Children's Hospital, 3000 CB, Rotterdam, The Netherlands, h.marrounel@erasmusmc.nl.
authors.forename: Hanan
authors.initials: H
authors.lastname: El Marroun
authors.forename: Tonya
authors.initials: T
authors.lastname: White
authors.forename: Frank C
authors.initials: FC
authors.lastname: Verhulst
authors.forename: Henning
authors.initials: H
authors.lastname: Tiemeier
mesh_terms: D000818:Animals; D014151:Anti-Anxiety Agents / Q000009:adverse effects* / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D002648:Child; D002653:Child Behavior Disorders / Q000139:chemically induced* / Q000453:epidemiology; D002658:Developmental Disabilities / Q000139:chemically induced* / Q000453:epidemiology; D005260:Female; D006801:Humans; D008431:Maternal-Fetal Exchange; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000139:chemically induced* / Q000453:epidemiology
chemical_list: D014151:Anti-Anxiety Agents; D000928:Antidepressive Agents