Prenatal antipsychotic exposure and neuromotor performance during infancy

Katrina C. Johnson, Jamie L. LaPrairie, Patricia A. Brennan, Zachary N. Stowe, Donald J Newport

Research output: Contribution to journalArticle

66 Citations (Scopus)

Abstract

Context: Despite the expanding clinical utility of antipsychotics beyond psychotic disorders to include depressive, bipolar, and anxiety disorders, reproductive safety data regarding the neurodevelopmental sequelae of fetal antipsychotic exposure are scarce. Objective: To examine whether intrauterine antipsychotic exposure is associated with deficits in neuromotor performance and habituation in 6-month-old infants. Design, Setting, and Participants: A prospective controlled study was conducted from December 1999 through June 2008 at the Infant Development Laboratory of the Emory Psychological Center examining maternalinfant dyads (N=309) at 6 months postpartum with pregnancy exposure to antipsychotics (n=22), antidepressants (n=202), or no psychotropic agents (n=85). Examiners masked to maternal-infant exposure status administered a standardized neuromotor examination (Infant Neurological International Battery [INFANIB]) that tests posture, tone, reflexes, and motor skills and a visual habituation paradigm using a neutral female face. Main Outcome Measures: The INFANIB composite score; number of trials required to achieve a 50% decrease in infant fixation during a visual habituation task; and mean time looking at the stimulus across 10 trials. Results: Infants prenatally exposed to antipsychotics (mean=64.71) showed significantly lower INFANIB scores than those with antidepressant (mean=68.57) or no psychotropic (mean=71.19) exposure, after controlling for significant covariates (F2,281=4.51; P=.01; partial η2=0.033). The INFANIB scores were also significantly associated with maternal psychiatric history, including depression, psychosis, and overall severity/chronicity (P's<.05) and maternal depression during pregnancy was associated with less efficient habituation (r245=0.16; P<.02). There were no significant differences regarding habituation between medication exposure groups. Conclusions: Among 6-month-old infants, a history of intrauterine antipsychotic exposure, compared with antidepressant or no psychotropic exposure, was associated with significantly lower scores on a standard test of neuromotor performance, highlighting the need for further scrutiny of the reproductive safety and neurodevelopmental sequelae of fetal antipsychotic exposure. Disentangling medication effects from maternal illness effects, which also contributed, remains a critical challenge.

Original languageEnglish (US)
Pages (from-to)787-794
Number of pages8
JournalArchives of General Psychiatry
Volume69
Issue number8
DOIs
StatePublished - Aug 2012
Externally publishedYes

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Antipsychotic Agents
Antidepressive Agents
Psychotic Disorders
Mothers
Depression
Safety
Infancy
Maternal Exposure
Pregnancy
Motor Skills
Neurologic Examination
Depressive Disorder
Child Development
Anxiety Disorders
Posture
Bipolar Disorder
Postpartum Period
Psychiatry
Reflex
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Arts and Humanities (miscellaneous)

Cite this

Prenatal antipsychotic exposure and neuromotor performance during infancy. / Johnson, Katrina C.; LaPrairie, Jamie L.; Brennan, Patricia A.; Stowe, Zachary N.; Newport, Donald J.

In: Archives of General Psychiatry, Vol. 69, No. 8, 08.2012, p. 787-794.

Research output: Contribution to journalArticle

Johnson, Katrina C. ; LaPrairie, Jamie L. ; Brennan, Patricia A. ; Stowe, Zachary N. ; Newport, Donald J. / Prenatal antipsychotic exposure and neuromotor performance during infancy. In: Archives of General Psychiatry. 2012 ; Vol. 69, No. 8. pp. 787-794.
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