Prenatal Antidepressant Exposure and Risk of Depression and Anxiety Disorders: An Electronic Health Records–Based Cohort Study - 12/05/25

Doi : 10.1016/j.jaac.2025.03.026

Ardesheer Talati, PhD ^a,^b,^⁎ , Jennifer L. Vande Voort, MD ^c, Launia J. White, BS ^d, David Hodge, MS ^d, Cynthia J. Stoppel, BS ^c, Myrna M. Weissman, PhD ^a,^b, Jay A. Gingrich, MD, PhD ^a,^b, William V. Bobo, MD, MPH ^d
^a Columbia University Irving Medical Center/Vagelos College of Physicians & Surgeons, New York, New York
^b New York State Psychiatric Institute, New York, New York
^c Mayo Clinic, Rochester, Minnesota
^d Mayo Clinic, Jacksonville, Florida

^∗Correspondence to Ardesheer Talati, PhD, Department of Psychiatry, Columbia Irving Medical Center,1051 Riverside Drive, New York, NY 10032Department of PsychiatryColumbia Irving Medical Center1051 Riverside DriveNew YorkNY10032

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Monday 12 May 2025

Abstract

Objective

To examine the associations of serotonergic antidepressant exposure during pregnancy with the risk of depression and anxiety disorders in offspring.

Method

The Mayo Clinic Rochester Epidemiology Project medical records-linkage system was used to study offspring born to mothers who were prescribed a selective serotonin reuptake inhibitor or serotonin-norepinephrine reuptake inhibitor (S/NRI users, n = 837) during pregnancy (1997-2010). Cox regression models were used to calculate hazard ratios to examine associations of S/NRIs with diagnosed depression and anxiety, defined based on a review of medical records by 2 board-certified psychiatrists, vs no maternal antidepressant use during pregnancy (nonusers, n = 863) and maternal antidepressant use in the year prior to pregnancy (former users, n = 399) as control groups.

Results

After all adjustments for covariates, children born to S/NRI users during pregnancy did not differ in onset of depression or anxiety from the children of nonusers (adjusted hazard ratio = 1.00, 95% CI [0.74, 1.85]) or former users (adjusted hazard ratio = 0.94, 95% CI [0.69, 1.27]). These associations were similar when exposure was limited only to selective serotonin reuptake inhibitors.

Conclusion

The results suggest that higher rates of childhood and adolescent depression or anxiety conditioned on maternal S/NRI use in pregnancy are more likely to be driven by maternal depression or underlying propensity for depression rather than direct pharmacological effects of in utero S/NRI exposure.

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Key words : antidepressant, depression, pregnancy, prenatal, SSRI

Plan

Method

Data Source and Study Sample

Association of Prenatal Antidepressants With Depression or Anxiety in Offspring

Sensitivity Analyses

Discussion

CRediT authorship contribution statement

	This study was funded by the National Institute of Mental Health R01MH114967 (Talati, principal investigator).
	This study used the resources of the Rochester Epidemiology Project (REP) medical records-linkage system, which is supported by the National Institute on Aging (AG 058738), by the Mayo Clinic Research Committee, and by fees paid annually by REP users. The content of this article is solely the responsibility of the authors and does not represent the official views of the National Institutes of Health or the Mayo Clinic.
	Data Sharing: This is a cohort built on electronic health record data, and data are not available.
	David Hodge, MS, served as the statistical expert for this research.
	Disclosure: Myrna M. Weissman has received book royalties from Perseus Press, Oxford Press, and APA Publishing Press. William V. Bobo’s research has been additionally supported by Agency for Healthcare Research and Quality, the Myocarditis Foundation, the Watzinger Foundation, the Blue Gator Foundation, and the Mayo Foundation for Medical Education and Research. None of these present conflicts of interest pertinent to this study. Ardesheer Talati, Jennifer L. Vande Voort, Launia J. White, David Hodge, Cynthia J. Stoppel, and Jay A. Gingrich report no biomedical financial interests or potential conflicts of interest.