Associations of Prenatal Depression and Selective Serotonin Reuptake Inhibitor (SSRI) Treatment with Early Child Development

Sunday, August 28, 2022

2:40 PM – 2:45 PM CEST

Location: C1M2

Publication Number: 280

Background: The knowledge gap regarding the risk associated with untreated prenatal depression and SSRI treatment on development of the offspring presents a treatment dilemma for pregnant women and clinicians.

Objectives: To assess the association between prenatal depression and SSRI exposure on speech and language delays and motor delays.

Methods: We conducted a longitudinal birth cohort study of children born between 2013 and 2019 to pregnant Kaiser Permanente Northern California (KPNC) members. Electronic health records (EHR) were used to extract exposure, outcome and covariate data. Women were categorized into 4 prenatal depression categories: no depression, untreated, treated with SSRIs, treated with psychotherapy only. Speech and motor delays diagnoses as well as depression severity (PHQ-9 scores) were ascertained from the EHR. Cox proportional hazards models were conducted adjusting for depression severity and potential confounders. Additional analyses taking into account medication possession ratio (MPR), and trimester of exposure will be conducted.

Results: Of the 247,534 births, 82% (n=207,315) were to women with no evidence of depression during pregnancy, 9% (n=23,135) with untreated depression, 4% (n=9,419) treated with SSRIs, and 2% (n=6,153) treated with psychotherapy only. Preliminary analyses suggest women with untreated depression had a 14% increased risk of speech and language delays (aRR:1.14, 95% CI: 1.07, 1.21) and 32% increased risk of motor delay (aRR: 1.32, 95%CI: 1.17, 1.48) compared to women with no prenatal depression. Treatment with SSRIs was associated with a 19% increased risk of speech and language delay (aRR: 1.19, 95%CI: 1.09, 1.31) and 58% increased risk of motor delay (aRR: 1.58, 95%CI: 1.33, 1.87) compared with untreated depression, after additionally adjusting for depression severity. There was no difference in risk of speech and language delays or motor delays for treatment with psychotherapy only compared to untreated prenatal depression.

Conclusions: Findings suggest a risk of speech and language delays and motor delays associated with the underlying depression and that treatment with SSRIs may impart an additional risk even after taking into account depression severity.

Presenting Author(s)

Lyndsay Avalos

Kaiser Permanente Northern California Division of Research
Kaiser Permanente Northern California, Division of Research
Oakland, California, United States

Slides

Co-Author(s)

NN

Nerissa Nance, MPH

Kaiser Permanente Northern California Division of Research, United States
AS

Ayesha Sujan, PhD

Kaiser Permanente Northern California Division of Research, United States
KR

Kathryn Ridout, MD, PhD

The Permanente Medical Group, United States
DE-KUN LI, MD, PhD

Senior Research Scientist III
Division of Research, Kaiser Foundation Research Institute
Oakland, California, United States
CQ

Charles Quesenberry, PhD

Kaiser Permanente Northern California Division of Research
Oakland, CA, United States
MD

Meghan Davignon, MD

The Permanente Medical Group, United States
LC

Lisa Croen, PhD

Kaiser Permanente Northern California Division of Research, United States
MB

Mibhali Bhalala, MD

The Permanente Medical Group, United States