Antidepressants During Pregnancy May Impact Newborn Behavior

Symptoms of neonatal discontinuation syndrome may result in preterm birth rather than antidepressant use.

Newborn babies exposed to antidepressants or mood disorder medications in utero were not observed to display more signs of Neonatal Discontinuation Syndrome (NDS) 2 to 4 weeks after birth compared with newborns not exposed to the drugs, according to a new study published by the Journal of Clinical Psychiatry.

Despite the lack of NDS symptoms, the babies exposed to these drugs were more likely to be preterm. These findings suggest that the drugs may not be entirely safe during pregnancy. Additionally, many other studies suggest that antidepressants can result in birth defects.

Similar studies have examined the risks of antidepressants on newborns less than 2-weeks-old. The authors indicate that the additional time allowed the authors to determine that preterm birth lead to neonatal signs of NDS, such as agitation, excessive crying, rigidity, tremors, and restlessness, according to the study.

Many mothers are concerned about taking the drugs because of the prevalence of NDS symptoms among babies exposed to antidepressants.

"I believe that is true directly after birth, but this study shows those signs appear to be short-lived," said senior author Katherine Wisner, MD. "At 2 to 4 weeks postpartum, the signs women were reporting to us were more associated with preterm birth rather than whether their babies were exposed."

The additional time also allowed parents to adjust to their newborns to better determine if the child’s behavior was concerning. Parents were able to look for signs that may not be present during a typical physician visit, such as sleep duration after feeding, fever, projectile vomiting, and stool, according to the study.

"Most pregnant women are naturally going to worry more about their baby's health than their own and might forego taking an antidepressant to avoid these neonatal signs," said first author Amy Yang. "But with the information from this study, they can be reassured that the baby's behavior at 2 to 4 weeks after birth is not likely due to exposure to medication or depression."

Included in the study were 214 women split into 3 groups: patients with a mood disorder who were not taking antidepressants; patients with a mood disorder who were treated with a serotonin reuptake inhibitor (SRI) antidepressant; and women without a mood disorder who were not taking an SRI antidepressant.

Infants were evaluated for signs on the Finnegan Scale, which lists symptoms commonly observed in infants exposed to drugs.

The authors found that 34.1% of participants in the SRI group reported the symptoms, while 35.1% of mothers in the mood disorder cohort reported the symptoms, according to the study. Additionally, only 30.4% of control patients reported the symptoms.

"We observed a significant relationship between Finnegan signs and preterm birth independent of SRI antidepressant exposure," Yang said. "Studies of NDS should consider the contribution of preterm birth to infant behavior."