![]() According to a Dutch study ( Ververs et al., 2006), 2% of childbearing parents take antidepressants (ADs) during pregnancy. ![]() Therefore, it is important to treat perinatal depression by choosing safe treatment for the pregnant parent and the unborn child after careful consideration.Ī descriptive drug utilization study on six European regions found that a weighted average of 2.5% of pregnancies in the period 2004–2010 were exposed to selective serotonin reuptake inhibitors (SSRIs) ( Charlton et al., 2015). ![]() This association may be caused by unhealthy lifestyle and poor adherence to prenatal care by depressed parents, which could harm both parent and child. Untreated severe depression during pregnancy has been associated with increased incidence of adverse birth outcomes such as premature birth and low birth weight ( Bonari et al., 2004 Meltzer-Brody, 2011). The rate of depression during pregnancy is approximately 17% according to a meta-analysis on 15 studies from year 2000–2016, with rates ranging between 4.8% and 33.2% ( Underwood et al., 2016). The extent to which depression in the pregnant parent could cause mental disorders such as ADHD in offspring, and the mechanisms involved, should be investigated in further studies. This perceived association may be caused (at least partially) by confounding by indication. The present study provides further evidence that an association between in utero AD exposure and ADHD in offspring might not exist. The secondary analyses revealed no statistically significant associations either. This indicates no increased risk of ADHD in offspring following in utero exposure to ADs. After adjusting for the birth date of the child (as a proxy for the date of pregnancy), age of the pregnant parent at birth, use of psychostimulants, opioids, and antiepileptic drugs by the pregnant parent in the 15 months before birth of the child, an adjusted OR of 1.11 (95% CI 0.67–1.83) was found for the risk of ADHD in the offspring when exposed in utero to ADs. Exposure rate to ADs among cases and controls was 2.2% and 2.4%, respectively. In total, 2,833 children (1,304 cases and 1,529 controls) were included in the analysis. Univariate and multivariate logistic regression was used to estimate odds ratios (ORs) with corresponding 95% confidence intervals (CI). Secondary analyses were performed to assess the effects of the degree of exposure (the amount of Defined Daily Doses) and the type of AD exposed to. Exposure was defined as at least two prescriptions for any AD during pregnancy, i.e., the period of 39 weeks before the birth date of the offspring. Children receiving medication for ADHD (cases) before the age of 16 years were matched to siblings not receiving such medication (controls). To control for unmeasured factors between pregnancies carried by the same parent, we set up a case-control sibling study using the University of Groningen prescription database. However, the association might be confounded by risk factors in the pregnant parent. Recent studies have reported an association between antidepressant (AD) use during pregnancy and the risk to develop attention-deficit/hyperactivity disorder (ADHD) in the offspring.
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