(215) Prenatal Exposure to Antidepressants and Risk of Overweight and Obesity in Offspring at Age 8 Years

Publication Number: 546

Background: The metabolic reproductive safety of antidepressant exposure in pregnancy on the offspring is unknown.

Objectives: To determine sex-specific associations between child obesity and overweight at age 8 years, and prenatal antidepressant exposure accounting for confounding by genetic.

Methods:

Design: The prospective, nationwide, Norwegian Mother, Father and Child Cohort Study, linked to MoBagenetics and the Norwegian Medical Birth Registry.
Setting: Norway, nationwide, 1999-2008. The population included 2956 8-year old children (1514 males and 1442 females) born to women with depression/anxiety prior to pregnancy.
Exposure: Maternal report on antidepressant treatment in pregnancy, defined as: i) continued antidepressants into during pregnancy (n=293); ii) initiated antidepressants in pregnancy (n=76); iii) discontinued treatment before pregnancy (n=180); or iv) non-exposure to antidepressants neither before nor during pregnancy (n=2407).
Main outcome measure: Children were classified as overweight or obese according to the international definition by sex and age.
Statistical analysis: We adjusted for confounding, including parental polygenic risk score for BMI and depression, via inverse probability of treatment weights methods. We fit modified Poisson regression with robust variance.

Results: Overall, 377 (12.8%) children were overweight and 91 (3.1%) obese. The proportion of overweight and obesity in male offspring were respectively 12.1% and 2.3% in non-exposed, 13.6% and 2.6% in continuers, 14.1% and 2.0% in discontinuers. In female offspring, these proportions were respectively 12.3% and 4.7%, 17.3% and 3.6%, 12.4% and 3.7%; 25.0% of female offspring born to antidepressant initiators were overweight. After weighting, there was no difference in the risk for overweight with antidepressant continuation relative to discontinuation before pregnancy, in both males (weighted RR: 0.88, 95% CI: 0.54, 1.44) and females (weighted RR: 0.80, 95% CI: 0.36, 1.80). Similar results were observed in relation to obesity and when unexposed acted as comparator. When comparing antidepressant initiators to continuers, the weighted RR for overweight was 1.07 (0.76-1.48) and similarly for obesity (weighted RR: 1.14, 95% CI: 0.82, 1.60), and no sex-specific differences were noted.

Conclusions: In this population of children born to women with depression/anxiety prior to pregnancy, continuation of antidepressant treatment into pregnancy was not linked to overweight or obesity in the offspring at age 8 years after taking into account multiple confounders including parental genetic.