Summary: A new study found that treating postnatal depression with selective serotonin reuptake inhibitors (SSRIs) benefits not just mothers but also their children.
The study, which analyzed data from over 61,000 mothers and their children, shows that SSRI treatment led to better outcomes up to five years after childbirth. This includes reduced maternal depression, improved partner relationships, and fewer child behavioral difficulties such as ADHD symptoms.
The findings challenge concerns about the long-term impact of SSRIs, suggesting they offer a net positive effect for families affected by postnatal depression.
Key Facts:
- The study analyzed data from over 61,000 mothers and children, making it one of the largest studies of its kind.
- SSRI treatment for postnatal depression was found to benefit mothers and their children up to five years after childbirth.
- The study found no evidence suggesting SSRIs increased risks for child development, dispelling longstanding concerns.
Source: King’s College London
New research led by the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London has found that selective serotonin reuptake inhibitor (SSRI) treatment for postnatal depression is associated with improvements in child behaviour up to five years after childbirth.
Up to 15% of women experience postnatal depression which has been shown to be associated with poor outcomes for mothers’ and their children.
Researchers at King’s IoPPN, in collaboration with the University of Oslo, analysed data from over 61,000 mothers and their children recruited during pregnancy from the Norwegian Mother, Father and Child Cohort Study.
The researchers investigated how postnatal SSRI treatment modified the negative outcomes associated with postnatal depression in mothers and their children.
The study, published in JAMA Network Open, found that SSRI treatment for postnatal depression was associated with better outcomes up to five years after childbirth than mothers with postnatal depression who did not take SSRIs.
These included reduced child behavioural difficulties (such as conduct problems and antisocial behaviour), child ADHD symptoms and maternal depression, as well as improved satisfaction in partner relationships.
The findings suggest that SSRI treatment could bring mid- to long-term benefits to women with postnatal depression and their children by reducing the risk of several negative outcomes that are associated with postnatal depression.
Dr Kate Liu, Research Associate at King’s IoPPN and first author of the study, said: “Postnatal depression is a common psychiatric disorder that affects 10 to 15 per cent of women in the first year after childbirth. In the UK however, only three per cent of women with postnatal depression receive SSRI treatment.
“This is likely due to a lack of awareness of postnatal depression, alongside concerns about the long-term impact that taking antidepressant medications in the postnatal period may have on child outcomes.
“Our study found no evidence suggesting that postnatal SSRI treatment conferred an increased risk for child development. In fact, we found that postnatal SSRI treatment reduced maternal depression and child behavioural difficulties that are associated with postnatal depression.”
Of the 61,081 mothers recruited in week 17-18 of pregnancy, 8,671 met the diagnostic criteria for postnatal depression at six months postpartum and 177 of these received postnatal SSRI treatment.
Mother and child outcomes, including maternal depression and child emotional and behavioural difficulties, were measured when the child was ages 1.5, three and five. Maternal reported partner relationship satisfaction was measured at six months, 1.5 years and three years postpartum.
Researchers found that more severe postnatal depression was associated with higher levels of future maternal depression, poorer partner relationship satisfaction, higher levels of child emotional and behavioural difficulties, poorer motor and language development and increased ADHD symptoms.
Postnatal SSRI treatment mitigated the association between postnatal depression and maternal depression at 1.5 and five years postpartum, child behavioural difficulties at ages 1.5 and five years, ADHD symptoms at age five, and relationship satisfaction across all measured timepoints.
In addition, postnatal SSRI treatment mitigated the negative association between postnatal depression symptoms and maternal depression at five years postpartum even when the level of postnatal depression did not meet the researchers’ diagnostic threshold.
Dr Tom McAdams, Wellcome Trust Senior Research Fellow at King’s IoPPN and senior author of the study, said: “Postnatal depression is under-recognised and undertreated. It’s critical that we view it as the severe mental illness that it is and ensure it is treated properly to mitigate some of the associated negative outcomes in mothers, children and wider family. Our study found no evidence that SSRI treatment for mothers affected by postnatal depression was linked with an increased risk for childhood emotional difficulties, behavioural problems or motor and language delay.”
Funding: The study was supported by funding from Wellcome and The Research Council of Norway.
About this psychopharmacology and neurodevelopment research news
Author: Amelia Remmington
Source: King’s College London
Contact: Amelia Remmington – King’s College London
Image: The image is credited to Neuroscience News
Original Research: Open access.
“Long-term maternal and child outcomes following postnatal Selective Serotonin Reuptake Inhibitor treatment” by Kate Liu et al. JAMA Network Open
Abstract
Long-term maternal and child outcomes following postnatal Selective Serotonin Reuptake Inhibitor treatment
Importance
Although selective serotonin reuptake inhibitors (SSRIs) are recommended for postnatal depression treatment, there is a lack of evidence regarding long-term maternal and child outcomes following postnatal SSRI treatment.
Objective
To examine whether postnatal SSRI treatment moderated postnatal depression–associated maternal and child outcomes across early childhood years.
Design, Setting, and Participants
This cohort study used longitudinal data from the Norwegian Mother, Father and Child Cohort Study. Participating women were recruited in weeks 17 to 18 of pregnancy from 1999 to 2008 and were prospectively followed up after childbirth. Data analysis was performed between December 2021 to October 2022.
Exposure
Postnatal depression diagnosis (a binary indicator of eligibility for treatment) was defined as a score of 7 or greater on the 6-item version of the Edinburgh Postnatal Depression Scale. The Hopkins Symptom Checklist was used as a continuous indicator of and postnatal depressive symptomology at postpartum month 6. Postnatal SSRI treatment was identified using self-reported data at postpartum month 6.
Main Outcomes and Measures
Maternal outcomes included self-reported depression symptomology and relationship satisfaction from childbirth to postpartum year 5. Child outcomes included maternal-report internalizing and externalizing problems, attention-deficit/hyperactivity disorder symptoms, and motor and language development at ages 1.5, 3, and 5 years. A propensity score adjustment method was used to control for prenatal factors associated with postnatal SSRI exposure probability.
Results
Among a total of 61 081 mother-child dyads, 8671 (14.2%) (mean [SD] age, 29.93 [4.76] years) met the criteria for postnatal depression diagnosis, 177 (2.0%) (mean [SD] age, 30.20 [5.01] years) of whom received postnatal SSRI treatment. More severe postnatal depression symptomology was associated with a range of adverse maternal and child outcomes.
Focusing analyses only on the postnatal depression dyads indicated that postnatal SSRI treatment attenuated negative associations between postnatal depression and maternal relationship satisfaction at postpartum month 6 (moderation β, 0.13; 95% CI, 0.07-0.19), years 1.5 (moderation β, 0.11; 95% CI, 0.05-0.18) and 3 (moderation β, 0.12; 95% CI, 0.04-0.19), and for child ADHD at age 5 years (moderation β, −0.15; 95% CI, −0.24 to −0.05).
Postnatal SSRI treatment mitigated the negative associations between postnatal depression and maternal depression, partner relationship satisfaction, child externalizing problems, and attention-deficit/hyperactivity disorder up to 5 years after childbirth.
Conclusions and Relevance
The results of this large prospective cohort study suggest that postnatal SSRI treatment was associated with a reduced risk of postnatal depression–associated maternal mental health problems and child externalizing behaviors across early childhood years. These findings suggest that postnatal SSRI treatment may bring benefits in the long term to women with postnatal depression and their offspring.
This study potentially provides valuable information for clinicians and women with postnatal depression to make informed treatment decisions.
