Motor development in children prenatally exposed to selective serotonin reuptake inhibitors: a large population-based pregnancy cohort study

Abstract

Objectives: To estimate the association between prenatal exposure to selective serotonin reuptake inhibitors (SSRIs) and motor development in children considering the effect of maternal symptoms of anxiety and depression before, during and after pregnancy.

Design: Population-based prospective pregnancy cohort study.

Setting: The Norwegian Mother and Child Cohort study (MoBa) (1999-2008).

Population: A total of 51 404 singleton pregnancies.

Methods: Self-reported use of SSRIs was collected for the 6 months before pregnancy and prospectively during pregnancy. We used ordinal logistic regression as the statistical analysis.

Main outcome measures: Motor development was assessed by maternal reports of fine and gross motor development at child age 3 years by items from the Ages and Stages Questionnaire (ASQ). The maternal ASQ scores were compared with data from a MoBa sub-study where clinicians assessed motor development with the Gross and Fine Motor Mullen scales of early learning.

Results: In all 381 women (0.7%) reported use of SSRIs during pregnancy, of these 159 reported on at least two questionnaires (prolonged use). Prolonged SSRI exposure was associated with a delay in fine motor development, odds ratio 1.42 (95% CI 1.07-1.87) compared with no SSRI exposure, after adjusting for symptoms of anxiety and depression before and during pregnancy. Severity of maternal depression seemed to explain the association only partially. Stratifying on depression after pregnancy had no impact on the estimated effect of SSRIs.

Conclusions: Prolonged prenatal exposure to SSRIs was weakly associated with a delayed motor development at age 3 years, but not to the extent that the delay was of clinical importance.

Tweetable abstract: Long-term prenatal SSRI exposure is weakly associated with delayed motor development independent of depression.

Keywords: Anxiety; Norwegian Mother and Child Cohort study (MoBa); cohort studies; depression; pregnancy; psychomotor disorder; selective serotonin reuptake inhibitors.