Brandlistuen Ragnhild Eek, Ystrom Eivind, Eberhard-Gran Malin, Nulman Irena, Koren Gideon, Nordeng Hedvig
Pharmacoepidemiology and Drug Safety Research Group, School of Pharmacy, University of Oslo, Oslo, Norway, Division of Mental Health, Norwegian Institute of Public Health, Oslo, Norway,
Division of Mental Health, Norwegian Institute of Public Health, Oslo, Norway, Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway and.
Int J Epidemiol. 2015 Aug;44(4):1397-407. doi: 10.1093/ije/dyv030. Epub 2015 Apr 14.
Potential adverse effects of prenatal antidepressant exposure on child development are still debated. The possibility that associations are due to genetic or familial environmental risk factors rather than antidepressant use per se cannot easily be ruled out in conventional studies. Our objective was therefore to evaluate the association between prenatal antidepressant exposure and behavioural problems in a sibling controlled study.
This study used data on 20 180 siblings identified from the population-based Norwegian Mother and Child Cohort Study recruited between 1999 and 2008. The mothers were asked to report antidepressant use at gestational weeks 17 and 30 and 6 months post-partum. Child Behavioral Checklist syndrome scales were used to assess externalizing and internalizing behavioural problems by questionnaires sent to mothers at 18 and 36 months postpartum. We performed unmatched and matched sibling analyses using both random- and fixed-effects linear models, respectively, to determine potential behavioural effects of antidepressant exposure.
Prenatal exposure to antidepressants was associated with increased levels of anxiety symptoms in 3 year old children after adjusting for maternal familial effects and confounding by indication (i.e. maternal depression). Effect of prenatal exposure to antidepressants was specific to anxiety, and not associated with emotional reactivity, somatic complaints, sleep problems, attention problems or aggression.
Using a sibling design, we showed that prenatal antidepressant use was specifically associated with increased anxiety symptoms after adjusting for maternal familial factors and confounding by indication.
产前暴露于抗抑郁药对儿童发育的潜在不良影响仍存在争议。在传统研究中，很难排除这种关联是由于遗传或家族环境风险因素而非抗抑郁药本身使用所致的可能性。因此，我们的目的是在一项同胞对照研究中评估产前抗抑郁药暴露与行为问题之间的关联。
本研究使用了从1999年至2008年招募的基于人群的挪威母婴队列研究中确定的20180对同胞的数据。母亲们被要求报告在妊娠第17周、30周和产后6个月时使用抗抑郁药的情况。通过在产后18个月和36个月向母亲发送问卷，使用儿童行为检查表综合征量表来评估外化和内化行为问题。我们分别使用随机效应和固定效应线性模型进行了 unmatched 和匹配的同胞分析，以确定抗抑郁药暴露的潜在行为影响。
在调整了母亲家族效应和指征混杂因素（即母亲抑郁）后，产前暴露于抗抑郁药与3岁儿童焦虑症状水平升高有关。产前暴露于抗抑郁药的影响特定于焦虑，与情绪反应性、躯体不适、睡眠问题、注意力问题或攻击行为无关。
使用同胞设计，我们表明在调整了母亲家族因素和指征混杂因素后，产前使用抗抑郁药与焦虑症状增加有特定关联。
