An alarming new study furthers the case for avoiding anti-depressants when pregnant

Pregnancy can be a stressful time for many women, but particularly for women that have to manage their own illnesses while caring for their unborn baby. Things that are relatively safe for a prospective mother may have huge consequences for their fetuses, like alcohol, Tylenol, and even certain viral infections.

Moms also now have a new reason to be wary of using medication for depression, called selective serotonin re-uptake inhibitors (SSRIs). In a massive study published on Wednesday (October 12) in JAMA Psychiatry, a team led by researchers at Columbia University Medical Center (CUMC) and Turku University in Finland linked a mother’s use of these drugs to speech and language disorders—conditions like trouble articulating certain sounds or learning new words. Children of mothers who filled a minimum of two prescriptions for SSRIs while pregnant were much more likely to have these types of speech and language disorders than those who did not use this medication.

SSRIs allow serotonin—a neurotransmitter linked with feelings of contentment— to linger in the brain by blocking the chemical from being reabsorbed in the body after its release. This helps steady patients’ moods, and is used as a result to treat depression, anxiety, and other kinds of mental health conditions.

Unfortunately in pregnant women, SSRIs are also capable of making their way into the placenta where they can harm babies growing in their mother’s uterus. SSRIs have already been connected to heart defects in babies, and some studies have shown they are linked to autism spectrum disorders, although these results haven’t been replicated widely.

The team wanted to look at other possible consequences of SSRIs in pregnant women. For their work, they followed a cohort of mothers and their children in Finland for 14 years from 1996 to 2010. Roughly 15,600 were mothers who had been diagnosed with depression or some other condition that could be treated with SSRIs, and had filled at least two prescriptions for these drugs while pregnant. Researchers restricted this group to mothers who ordered one kind of medication, to ensure they were following mothers who were likely not severely depressed and on multiple kinds of medication. About 9,500 pregnant mothers were diagnosed with depression, but weren’t receiving any drug treatment, and 31,000 mothers had neither. The team followed up with mothers and kids until the children were 14 years old to track whether any developed speech or language disorders.

The researchers found that the children of mothers who took SSRIs were 37% more likely to have speech or language disorders. For comparison, in the US, these disorders occur in about 8% to 9% of children.

This study was not able to identify how SSRIs may cause these disorders—especially considering it was only monitoring women who received prescriptions, and did not confirm the women were taking them. Alan Brown, a psychiatrist at CUMC and lead author of the paper, speculates the drugs may somehow interfere with the fetus’ growing brain. “Serotonin plays a key role in critical aspects of brain development and thus it is plausible that altering this system could impact on neural pathways that underlie speech and language,” he wrote an in email.

Brown noted that depression itself has implications for pregnancy, in some cases causing women to deliver their babies early, or with low birth weights, and that women with severe depression who may become suicidal or experience psychosis should take medication to preserve their health during pregnancy. But in light of the study’s results, Brown recommended that women with mild depression explore alternative treatments with their doctors, such as therapy.

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