Prenatal exposure to antidepressant medications and neurodevelopmental outcomes: a systematic review

In weighing the risk and benefits of pharmacological treatment of depression during pregnancy it is important to consider risks of long-term as well as short-term implications for children from exposure. Hence, this article examines the evidence to date of studies which have examined longer-term neurodevelopment teratogenic effects on child outcomes (including cognitive, motor and behavioral outcome measures) following in utero exposure to antidepressants.

A systematic review of published literature between January, 1973 and February, 2010 was conducted using the following key-words: pregnancy, child/infant development/neurodevelopment, antidepressants. All studies (N = 12) that reported primary data on neurodevelopmental outcome of infants exposed prenatally to antidepressants were assessed and analyzed.

The identified studies varied considerably in their own methodology, including the age of the children studied, the scales and assessments used, and the different aspects of neurodevelopment (such as cognitive, motor and behavioral outcomes) that were examined. Despite these limitations, the majority of studies found no difference between those exposed and controls on the various neurodevelopmental outcome measures, whereas only two studies identified statistically significant differences in motor function.

These preliminary reassuring results must be confirmed by larger studies with longer period of follow-up and providing more robust measures of neurodevelopmental outcome, in order to definitively exclude any potential risk of neurodevelopmental teratogenicity associated with antidepressant exposure in utero.