Prevalence of Neurodevelopmental Disorders in Families of Women Taking Psychotropic Medication During Pregnancy

Familial and environmental factors contribute to neurodevelopmental disorders (NDDs). Prenatal psychotropic exposure may influence the risk of NDDs in children. As these medications are prescribed to women with mental disorders, which are genetically and environmentally linked to NDDs, accounting for familial confounding is essential when studying medication safety in pregnancy.

To compare the prevalence of NDDs in pregnant women using psychotropics, their partners, and their previous children, with those not using these medications.

We included data from the most recent pregnancy of Norwegian women with mental disorders who gave birth between 2010 and 2018, using Norwegian registries. Maternal psychotropic use included antidepressants, antipsychotics, anxiolytics, hypnotics, and sedatives, as recorded in the Norwegian Prescription Database. NDDs were identified using ICD-10 codes for intellectual disabilities, language/scholastic disorders, pervasive developmental disorders, and attention-deficit hyperactivity disorders (ADHD) from the Norwegian Patient Registry. Modified Poisson regression estimated crude and adjusted relative risks (aRRs) for the association between psychotropic use and family history of NDDs.

The study included 27,638 women. Among psychotropic users, NDDs prevalence was 9.6% in women, 5.4% in partners, and 10.0% in previous children, compared to 5.7%, 4.6%, and 8.0% in non-users, respectively. ADHD was the most prevalent NDD. Psychotropic use in pregnancy was associated with any NDD, particularly ADHD, in the women [any NDD aRR 1.77 (95% CI 1.60, 1.95); ADHD aRR 1.79 (95% CI 1.61, 1.98)], previous children [any NDD aRR 1.25 (95% CI 1.07, 1.47); ADHD aRR 1.26 (95% CI 1.02, 1.54)], and partners [any NDD aRR 1.21 (95% CI 1.06, 1.37); ADHD aRR 1.22 (95% CI 1.07, 1.39)].

Prenatal psychotropic use was associated with a higher prevalence of NDDs in mothers and their previous children, highlighting the need to account for familial neurodevelopmental patterns to distinguish the effects of psychotropics from underlying genetic or familial factors.