Major depressive disorder during pregnancy

Psychiatric medications have minimal effects on the fetus and infant yet development is compromised

Hanna C. Gustafsson, Sherryl H. Goodman, Tianshu Feng, Jean Choi, Seonjoo Lee, Donald J Newport, Bettina Knight, Blaire Pingeton, Zachary N. Stowe, Catherine Monk

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Psychotropic medication use and psychiatric symptoms during pregnancy each are associated with adverse neurodevelopmental outcomes in offspring. Commonly, studies considering medication effects do not adequately assess symptoms, nor evaluate children when the effects are believed to occur, the fetal period. This study examined maternal serotonin reuptake inhibitor and polypharmacy use in relation to serial assessments of five indices of fetal neurobehavior and Bayley Scales of Infant Development at 12 months in N = 161 socioeconomically advantaged, non-Hispanic White women with a shared risk phenotype, diagnosed major depressive disorder. On average fetuses showed the expected development over gestation. In contrast, infant average Bayley psychomotor and mental development scores were low (M = 84.10 and M = 89.92, range of normal limits 85-114) with rates of delay more than 2-3 times what would be expected based on this measure's normative data. Controlling for prenatal and postnatal depressive symptoms, prenatal medication effects on neurobehavioral development were largely undetected in the fetus and infant. Mental health care directed primarily at symptoms may not address the additional psychosocial needs of women parenting infants. Speculatively, prenatal serotonin reuptake inhibitor exposure may act as a plasticity rather than risk factor, potentially enhancing receptivity to a nonoptimal postnatal environment in some mother-infant dyads.

Original languageEnglish (US)
Pages (from-to)773-785
Number of pages13
JournalDevelopment and Psychopathology
Volume30
Issue number3
DOIs
StatePublished - Aug 1 2018

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Major Depressive Disorder
Child Development
Psychiatry
Fetus
Pregnancy
Serotonin Uptake Inhibitors
Mothers
Polypharmacy
Parenting
Mental Health
Reference Values
Depression
Delivery of Health Care
Phenotype

ASJC Scopus subject areas

  • Developmental and Educational Psychology
  • Psychiatry and Mental health

Cite this

Major depressive disorder during pregnancy : Psychiatric medications have minimal effects on the fetus and infant yet development is compromised. / Gustafsson, Hanna C.; Goodman, Sherryl H.; Feng, Tianshu; Choi, Jean; Lee, Seonjoo; Newport, Donald J; Knight, Bettina; Pingeton, Blaire; Stowe, Zachary N.; Monk, Catherine.

In: Development and Psychopathology, Vol. 30, No. 3, 01.08.2018, p. 773-785.

Research output: Contribution to journalArticle

Gustafsson, Hanna C. ; Goodman, Sherryl H. ; Feng, Tianshu ; Choi, Jean ; Lee, Seonjoo ; Newport, Donald J ; Knight, Bettina ; Pingeton, Blaire ; Stowe, Zachary N. ; Monk, Catherine. / Major depressive disorder during pregnancy : Psychiatric medications have minimal effects on the fetus and infant yet development is compromised. In: Development and Psychopathology. 2018 ; Vol. 30, No. 3. pp. 773-785.
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