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Association of maternal depression and antidepressant use during pregnancy with child allergic risk: A nationwide
Jian-An Su1, Shung-Jie Chang2, Yao-Hsu Yang3
1Department of Psychiatry, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan; School of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Nursing, Chang Gung Institute of Technology, Taoyuan, Taiwan.
Insights
Maternal depression during pregnancy did not significantly increase offspring allergy risk after adjusting for confounders. Antidepressant use in mothers with depression also showed no increased risk for allergic diseases in children.
Area of Science:
- Perinatal Psychiatry
- Pediatric Allergy
- Epidemiology
Background:
- The relationship between maternal mental health during pregnancy and offspring allergic diseases is a critical area of research.
- Existing evidence is often limited by small sample sizes or inadequate control for confounding factors.
Purpose of the Study:
- To investigate the association between maternal depression, antidepressant use during pregnancy, and the risk of allergic diseases in offspring.
- To analyze these associations in a large, nationwide cohort to provide robust evidence.
Main Methods:
- A population-based cohort study utilizing Taiwanese birth and health insurance data from 2004-2020.
- Classification of mothers into non-depressed, depressed without antidepressants, and depressed with antidepressants groups.
- Follow-up of offspring for atopic dermatitis, allergic rhinitis, and asthma, with adjusted hazard ratios calculated via Cox models.
Main Results:
- Unadjusted analyses showed a link between maternal depression and increased offspring allergy risks.
- After adjusting for confounders, these associations were no longer statistically significant.
- Antidepressant use among mothers with depression did not elevate offspring allergy risks compared to non-use.
Conclusions:
- Maternal depression during pregnancy was not significantly associated with offspring allergic disease risk in the primary adjusted analysis.
- Antidepressant use during pregnancy was not linked to increased offspring allergic disease risk.
- Findings support informed risk-benefit discussions for antidepressant treatment during pregnancy.
Purpose:
Whether maternal depression or antidepressant use during pregnancy increases the risk of allergic diseases in offspring remains unclear. Hence, in this study, these associations were assessed in a large, nationwide cohort in Taiwan.
Methods:
This population-based cohort study used Taiwanese birth certificate and health insurance claims data, encompassing 2743,735 live births between 2004 and 2020. Mothers were classified into three groups: no depression and no antidepressant use (non-DEP), depression without antidepressant use (DEP-ATD), and depression with antidepressant use (DEP+ATD). Offspring were followed for the presence of atopic dermatitis, allergic rhinitis, and asthma. Adjusted hazard ratios (aHRs) were estimated using Cox models controlling for parental, perinatal, and medication-related factors.
Results:
In unadjusted analyses, maternal depression without antidepressant use was associated with higher risks of atopic dermatitis (HR = 1.15), allergic rhinitis (HR = 1.16), and asthma (HR = 1.12) in offspring (p < 0.001 for all). However, after adjustment, these associations were no longer statistically significant (e.g., for atopic dermatitis: aHR = 1.06, 95% CI = 0.99-1.15). Among mothers with depression, antidepressant use was not associated with higher risks than no antidepressant use (e.g., atopic dermatitis: aHR = 1.01, 95% CI = 0.93-1.10).
Conclusion:
In summary, after adjustment for measured confounders, no statistically significant association between maternal depression and offspring allergic disease risk was observed in the primary analysis, although a small association cannot be excluded. Among mothers with depression, antidepressant use during pregnancy was not associated with a higher risk of allergic diseases in offspring compared with no antidepressant use. These findings may inform individualized risk-benefit discussions regarding antidepressant treatment during pregnancy.
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