Department of Epidemiology, Institute of Public Health, Aarhus University, Bartolins Allé 2, DK-8000 Aarhus C, Denmark.
Pediatrics. 2010 Mar;125(3):e600-8. doi: 10.1542/peds.2008-3655. Epub 2010 Feb 22.
The goal was to investigate a possible association between exposure to antidepressants in utero and developmental milestones in early childhood.
Information on pregnancy exposures and developmental milestones at 6 and 19 months was obtained from the Danish National Birth Cohort. Of the eligible pregnant women, 415 used antidepressant medication, 489 reported depression with no medical treatment, and 81 042 reported no depression and no use of psychotropic medication.
Children with second- or third-trimester exposure to antidepressants were able to sit 15.9 days (95% confidence interval [CI]: 6.8-25.0) and to walk 28.9 days (95% CI: 15.0-42.7) later than children of women not exposed to antidepressants but still were within the normal range of development. Fewer children with second- or third-trimester exposure to antidepressants were able to sit without support at 6 months of age (odds ratio: 2.1 [95% CI: 1.23-3.60]), and fewer were able to occupy themselves at 19 months of age (odds ratio: 2.1 [95% CI: 1.09-4.02]). None of the other milestones measured showed statistically significant associations with antidepressant exposure.
The results of this study suggest a permanent or reversible effect of antidepressant exposure on fetal brain development, which may depend on the timing of exposure during pregnancy.
本研究旨在探讨胎儿期暴露于抗抑郁药与儿童早期发育里程碑之间的可能关联。
来自丹麦全国出生队列的信息提供了妊娠期间的暴露情况以及儿童 6 个月和 19 个月时的发育里程碑数据。在符合条件的孕妇中，415 名使用了抗抑郁药物，489 名报告了未经医学治疗的抑郁，81042 名报告了既无抑郁也未使用精神药物。
与未暴露于抗抑郁药的女性所生的儿童相比，在妊娠第二或第三期暴露于抗抑郁药的儿童独坐时间晚 15.9 天（95%置信区间：6.8-25.0），独走时间晚 28.9 天（95%置信区间：15.0-42.7），但仍在正常发育范围内。在 6 个月时，更少的第二或第三期暴露于抗抑郁药的儿童能够无支撑独坐（比值比：2.1 [95%置信区间：1.23-3.60]），更少的儿童在 19 个月时能够自我娱乐（比值比：2.1 [95%置信区间：1.09-4.02]）。其他测量的发育里程碑与抗抑郁药暴露均无统计学显著关联。
本研究结果提示抗抑郁药暴露对胎儿大脑发育有持久或可逆转的影响，其可能取决于妊娠期间暴露的时间。
