Internalizing Behaviors in 4-Year-Old Children Exposed in Utero to Psychotropic Medications
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Objective: Internalizing behaviors in children between 4 and 5 years of age who had been prenatally exposed to psychotropic medications were investigated. The authors had previously reported the effects of prenatal medication exposure in this same cohort when they were newborns and infants at 3 and 8 months of age. Method: Parental/teacher reports and a clinical measure of mother and child interactions were used to assess levels of internalizing behaviors (e.g., depression, anxiety, withdrawal). Outcomes were compared between children with prenatal selective serotonin reuptake inhibitor (SSRI) exposure (N=22) and nonexposed children of healthy, nondepressed, nonmedicated mothers (N=14). Measures of maternal mood were obtained. Ordered logistic regressions, independent-sample t tests, and univariate ANOVAs were used to compare outcomes between groups. Pearson correlations were used to determine associations between maternal mood and child behaviors. Results: Levels of internalizing behaviors did not differ significantly between children with prenatal psychotropic medication exposure and those not exposed. However, as symptoms of maternal anxiety and depression increased, so did reported internalizing behaviors in their children. Conclusions: Prenatal exposure to psychotropic medications was not associated with increased reports of internalizing behaviors at 4 years of age, whereas impaired maternal mood did have an identified impact on child behavior. Further study of complex associations between maternal psychiatric disorders, prenatal SSRI exposure, and childhood internalizing behaviors is required to understand if the child outcome is affected by the illness, medications, or a combination of both.
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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 [10]
The Discussion (p. 6) links maternal depression and anxiety with internalizing problems in children, supporting the concern about consequences for children. But the study could not assess untreated depressed mothers (Discussion, p. 6), and it does not establish negative consequences of untreated postpartum depression for mothers. (LLM, conf=0.86)
Experimental — accuracy not yet measuredNonsystematic 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 [10]
The introduction (p. 2) and Discussion (p. 6) describe maternal depression or anxiety as a risk factor for childhood behavioral problems, including an association with internalizing problems. But the Discussion (p. 6) says the study could not examine children of depressed mothers who were untreated, and the paper does not substantiate the full list of outcomes or the claimed comparison with mothers without PPD. The introduction (p. 2) also reports a study finding no cognitive-task deficits in children of postnatally depressed mothers. (LLM, conf=0.86)
Experimental — accuracy not yet measured
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- Authors
- Misri, S., Reebye, P., Kendrick, K., Carter, D., Ryan, D., Grunau, R. E., & Oberlander, T. F.
- Affiliations
- St. Paul's Hospital (CA)
- Corresponding author
- Misri, Shaila
- Venue
- American Journal of Psychiatry
- Published
- 2006-06
- Volume
- 163
- Issue
- 6
- Pages
- 1026-1032
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- OpenAlex
- W1989830600
- Cited by
- 207
- References
- 18
- Citations by year
- 2025: 4 · 2024: 6 · 2023: 10 · 2022: 12 · 2021: 5 · 2020: 8 · 2019: 12 · 2018: 6 · 2017: 12 · 2016: 13 · 2015: 8 · 2014: 19 · 2013: 12 · 2012: 11
- FWCI
- 11.98
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- American Journal of Psychiatry (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
- internalizing problems, selective serotonin reuptake inhibitors, maternal depression, maternal anxiety, maternal mood, child behavior, preschool children, mother-child interaction, maternal mental illness
- MeSH terms
- Adult, Affect, Age Factors, Anxiety Disorders, Child Behavior Disorders, Child, Preschool, Depressive Disorder, Female, Humans, Maternal-Fetal Exchange, Mother-Child Relations, Mothers, Pregnancy, Prenatal Exposure Delayed Effects, Psychotropic Drugs, Reproducibility of Results, Cohort Studies, Logistic Models, Child of Impaired Parents, Maternal Exposure
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