CIDRAP-Maternal depression tied to higher risk of special educational needs in kids

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Maternal depression tied to higher risk of special educational needs in kids

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Maternal depression tied to higher risk of special educational needs in kids​

Laine Bergeson

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Children whose mothers had depression during pregnancy are at higher risk of having special educational needs that can’t be attributed solely to antidepressant exposure, according to a study led by researchers from the University of Glasgow and published yesterday in PLOS Medicine.

Antidepressant use during pregnancy is on the rise, though the long-term effects of these drugs on child development is unclear. At the same time, having untreated depression during pregnancy carries its own risks, making it challenging for women to make informed decisions about medication use during pregnancy.

For the study, the researchers analyzed the health and education records of more than 167,000 children born in Wales from 2009 to 2016 and followed through 2022. They looked for indications of special educational needs, including learning and communication difficulties, autism, and behavioral or emotional difficulties, as well as attention-deficit hyperactivity disorder. They also examined maternal depression diagnoses and antidepressant prescriptions.

Antidepressants linked to slightly higher risk​

Of the roughly 167,000 children, 12,630 (7.6%) were exposed to untreated depression in utero, 7,005 (4.2%) were exposed to antidepressant-treated depression; and 5,996 (3.6%) were exposed to antidepressant medication without a recorded depression diagnosis.

After accounting for factors like maternal age, smoking, and the child’s sex, the researchers estimated that 20% of children exposed to neither depression nor antidepressant medications would have a special education need. That estimate rose to 23.6% among children whose mothers had depression but were not prescribed antidepressants.

Among children whose mothers had both depression and an antidepressant prescription, the estimate was 26.5%. The estimate was similar for children whose mothers had an antidepressant prescription but no recorded depression diagnosis: 26.3%.

Overall, the researchers found that antidepressant exposure was associated with a 6.3% rise in special education needs in those not exposed to maternal depression and an additional 2.9% increase in children exposed to maternal depression. The team concluded that mothers with depression have a higher risk of giving birth to children with special educational needs, regardless of whether they were exposed to antidepressants, but that medication may carry an additional risk.

“We showed that if women with depression took antidepressants while pregnant, their children were more likely to have special educational needs, but it was only a very slight increase and may have been due to them having more severe depression, rather than an effect of the medicine,” said the authors in a PLOS press release.

Untreated depression carries risks of its own​

The study cannot show that antidepressants caused the additional risk, say the researchers. The team had no measure of depression severity, and women prescribed medication may have had more severe symptoms than those who were not prescribed medication.

Previous research has linked maternal depression with special educational needs. “Specifically, previous systematic reviews and meta-analyses have found that untreated poor perinatal maternal mental health is associated with adverse neurodevelopment in school-age and adolescent children,” write the researchers.

The records also lacked information on other potentially relevant factors, including alcohol use and postpartum depression.

Our results don't suggest that women should automatically stop taking their antidepressants.

Hence, the findings do not provide a reason to stop antidepressant treatment during pregnancy, say the researchers. “Our study indicates that exposure to antidepressants during pregnancy could serve as a marker for additional support being needed at school,” they said.

But, “Our results don't suggest that women should automatically stop taking their antidepressants because depression can harm both mother and baby if not treated,” they added. “Women should always speak to their doctor about what is best in their situation.”

The American College of Obstetricians and Gynecologists recommends against discontinuing mental health medication solely because of pregnancy.