November 24, 2022

Antidepressants do not impact fetal neurodevelopment: study

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(CNN) — Mothers-to-be who take some of the most common antidepressants don’t have to worry that the medication could harm their child’s future neurological, behavioral or cognitive development, according to a new study of more than 145,000 women and their children across the United States. who were followed up to 14 years.

“Results from previous studies on this topic have been conflicting. Due to the large size of our population and careful study design, we believe our study offers clarity that could help patients and providers make treatment decisions.” in pregnancy,” said study author Elizabeth Suarez, an instructor in the Center for Pharmacoepidemiology and Treatment Sciences at the Rutgers Institute for Research on Health, Health Policy, and Aging.

Antidepressant use during pregnancy was not associated with autism, attention deficit hyperactivity disorder (ADHD), behavioral disorders, developmental disorders of speech, language, learning and coordination, or intellectual disabilities , according to him study, published Monday in the academic journal JAMA Internal Medicine.

“We believe these results are reassuring when it comes to concerns about potential effects on neurodevelopmental outcomes in children, especially for diagnoses that may be of greatest concern to prospective parents such as autism spectrum disorder,” Suarez said. via email.

“This is a really important article. Women and health professionals are often concerned about antidepressants in pregnancy, sometimes deciding to abruptly stop these medications as soon as the pregnancy is known,” said Carmine Pariante, professor of psychiatry. Biology at the Institute of Psychiatry, Psychology and Neuroscience at King’s College London, in a statement.

Instead, women with depression and other mental illnesses for whom antidepressants are prescribed should be told that the pregnancy risk “is not as high as previously thought,” said Pariante, who was not involved in the study.

“I am grateful for this study,” Dr. Tiffany Moore Simas, a member of the American College of Obstetrics and Gynecology Clinical Practice Guidelines Committee, told CNN by email.
“One in five perinatal people will experience a mental health condition,” said Moore Simas, who was not involved in the study. “We need to stop shaming them for doing what it takes to take care of themselves. Healthy babies need healthy mothers.”

a controversial topic

Numerous studies over the decades have found associations between antidepressant use during pregnancy and developmental problems in children, predominantly autism and ADHD. But more recent research has called into question the quality of earlier studies. Many of the older studies were observational in nature and often did not control for contributing factors such as obesity and other health problems, environmental toxins, inflammation, and even maternal stress.

The older research also did not take into account the impact on the development of the fetus of a mother with uncontrolled depression, anxiety or another psychiatric disorder. Not treating the mother’s mental disorder has also been linked to “stillbirth, preterm birth, growth restriction and birth weight problems, impaired bonding, adverse neurodevelopmental outcomes, and increased risk of mental health of the progeny,” said Moore Simas.

Depressed women may also miss prenatal visits, skip meals, abuse alcohol or tobacco and generally fail to care for their growing fetus as well as themselves, experts say.

According to the US Centers for Disease Control and Prevention (CDC), a very small number of antidepressants It has been linked to an increased risk of birth defects, so pregnant women should discuss their medication with their doctors.

“In our study, we did not take into account other possible adverse outcomes. Our results on neurodevelopmental disorders must be weighed against the risk of other outcomes, such as a possible slight increased risk of preterm birth, and the benefits of treatment,” Suarez said.

Despite advancing knowledge showing little or no impact of the most common antidepressants, many doctors and mothers-to-be remain wary of their use, Moore Simas said.

Discussions between pregnant women and their doctors about antidepressant use are often “framed in the context of medication risk, even though the data is generally reassuring,” she said. “Discussions about the use of mental health medications in pregnancy or otherwise should take into account the risk of untreated illness.”

The American College of Obstetricians and Gynecologists meets regularly to update guidance on medications that are safe to use during pregnancy, a spokesperson told CNN, and will review recent research, including this new study.



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