Infant developmental outcomes following prenatal exposure to antidepressants, and maternal depressed mood and positive affect

Background: Prenatal exposure to serotonin reuptake inhibitor (SRI) antidepressants has been associated with delays in early developmental milestones, but there remains uncertainty. Even among a subset of studies examining the Bayley Scales of Infant Development (BSID), some have reported normal mental and psychomotor development while others have suggested a delay in motor development. Given an increasing number of infants exposed to SRIs, furthering our understanding of the possible developmental implications of SRI exposure in utero is critical.

Aims: To examine the effects of prenatal serotonin reuptake inhibitor exposure and maternal mood on infant developmental outcomes at 10months of age.

Study design: Prospective study of mothers and their 10-month-old infants.

Subjects: We examined 31 mother-child pairs exposed prenatally to SRIs and 52 mother-child pairs who were nonexposed.

Outcome measure: The Bayley Scales of Infant Development (third edition) scores.

Results: Infants exposed prenatally to SRIs scored significantly lower than nonexposed infants on gross motor (P=0.03), social-emotional (P=0.04) and adaptive behavior (P=0.05) subscales of the BSID-III, controlling for pre- and postnatal maternal depressed mood, smoking and alcohol use during pregnancy. No significant differences in any of the BSID-III subscales were observed between infants exposed and infants nonexposed to pre and postnatal maternal depressed mood (P>0.05). Increased levels of maternal positive affect at 10 months predicted increased social-emotional scores (P=0.03).

Conclusions: Infants prenatally exposed to SRIs score significantly lower on the gross motor, social-emotional and adaptive behavior subscales of the BSID-III, and this was not explained by underlying maternal depression.