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Cited by 198Maternal Mental Health During Pregnancy and PostpartumPrenatal Substance Exposure EffectsPregnancy and Medication Impact

Externalizing and Attentional Behaviors in Children of Depressed Mothers Treated With a Selective Serotonin Reuptake Inhibitor Antidepressant During Pregnancy

Oberlander, Tim F., Reebye, Pratibha, Misri, Shaila, Papsdorf, Michael, Kim, John, Grunau, Ruth E.·2007·Archives of Pediatrics & Adolescent Medicine
DOI 10.1001/archpedi.161.1.22
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Abstract

OBJECTIVE: To evaluate attentional and activity behaviors in 4-year-olds following prenatal selective serotonin reuptake inhibitor (SSRI) exposure. DESIGN: Prospective cohort design. SETTING: Tertiary care center. PARTICIPANTS: Twenty-two 4-year-olds with prolonged prenatal SSRI medication exposure and 14 children without prenatal exposure. MAIN EXPOSURE: Prenatal SSRI exposure. MAIN OUTCOME MEASURES: Group differences in externalizing behaviors (according to the Child Behavior Checklist) and direct observations of child attention, activity, and impulsiveness in a laboratory setting using the procedure by Crowell and colleagues were compared, including measures of the duration of prenatal SSRI exposure, umbilical cord drug levels, a history of poor neonatal adaptation, and maternal mood. RESULTS: Externalizing behaviors did not differ between groups. Maternal depression and anxiety at the 4-year follow-up were associated with increased reports of externalizing behaviors. Increased externalizing behaviors were associated with increased umbilical cord drug levels (F(1,34) = 6.3; P = .02), but when controlling for maternal depressed mood at the 4-year follow-up, such levels only accounted for 11.2% of the behavioral outcomes (P>.05). On direct observation, the persistence score for child behavior was significantly lower in the exposed group. Increased aggressiveness scores were associated with a history of poor neonatal adaptation, even when parental report of stress was added to the model (F(1,34) = 4.0; P = .03); however, neither parental report of stress nor poor neonatal adaptation were significant (both P = .09), suggesting that both are important, if not unique, predictors of child behavior. CONCLUSIONS: These findings suggest that the best predictors of externalizing behaviors at age 4 years are current maternal mood and parental stress, regardless of prenatal depressed mood and SSRI treatment during pregnancy. It remains uncertain whether poor neonatal adaptation can be excluded as a possible predictor of externalizing behaviors.

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  • Nonsystematic reviews have indicated that the risks to children of untreated depressed mothers, compared to mothers without PPD, include poor cognitive functioning, behavioral inhibition, emotional maladjustment, violent behavior, externalizing disorders, and psychiatric and medical disorders in adolescence.

    “Nonsystematic reviews have indicated that the risks to children of untreated depressed mothers (compared to mothers without PPD) include problems such as poor cognitive functioning, behavioral inhibition, emotional maladjustment, violent behavior, externalizing disorders, and psychiatric and medical disorders in adolescence.5,10–17”

    From Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes (2019) · cites this paper as [13]

  • Untreated PPD seems to have negative consequences for both infants and mothers.

    “Untreated PPD seems to have negative consequences for both infants and mothers.”

    From Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes (2019) · cites this paper as [13]

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Authors
Oberlander, T. F., Reebye, P., Misri, S., Papsdorf, M., Kim, J., & Grunau, R. E.
Affiliations
University of British Columbia (CA)
ORCID
Venue
Archives of Pediatrics & Adolescent Medicine
Publisher
American Medical Association (AMA)
Published
2007-01-01
Volume
161
Issue
1
Pages
22
ISSN
1072-4710 (ISSN-L)
DOI
10.1001/archpedi.161.1.22
OpenAlex
W2164579326
Cited by
198
References
35
Citations by year
2026: 2 · 2025: 2 · 2024: 6 · 2023: 5 · 2022: 3 · 2021: 3 · 2020: 13 · 2019: 14 · 2018: 9 · 2017: 13 · 2016: 13 · 2015: 14 · 2014: 12 · 2013: 14 · 2012: 13
FWCI
15.10
Type
journal article
Language
en
Open access
closed
Locations
  • Archives of Pediatrics and Adolescent Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • Research Portal (Queen's University Belfast) (submittedVersion)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Substance Exposure Effects
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Pregnancy and Medication Impact
Keywords
prenatal SSRI exposure, selective serotonin reuptake inhibitors, maternal depression, externalizing problems, attention, impulsivity, neonatal adaptation, parental stress, maternal mood, child behavior, autism spectrum disorder risk
MeSH terms
Adult, Attention, Child Behavior, Child, Preschool, Depression, Female, Follow-Up Studies, Humans, Infant, Infant, Newborn, Male, Pregnancy, Pregnancy Complications, Prognosis, Prospective Studies, Risk Factors, Selective Serotonin Reuptake Inhibitors, Maternal Exposure

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