Prise d'antidépresseurs pendant la grossesse et développement psychomoteur, cognitif et langagier de l'enfant à 2 ans

Introduction : Environ 5.5% des femmes enceintes prennent des antidépresseurs. Les études sur l'exposition prénatale aux antidépresseurs rapportent l'absence d'association avec le développement cognitif de l'enfant et des résultats inconstants pour la motricité et le langage. Une limite est l'omission de contrôler pour la détresse maternelle prénatale. Objectifs : Évaluer les associations entre l'exposition aux antidépresseurs et le développement de l'enfant à deux ans en contrôlant pour la détresse psychologique prénatale. Explorer les effets indirects via les complications de naissance. Considérer les associations spécifiques au sexe. Méthodes : Étude ancillaire de l'Étude 3D. Un journal de médicaments a permis de recueillir les informations relatives aux antidépresseurs. Les symptômes dépressifs et le stress ont été évalués à l'aide de questionnaires auto-rapportés. Le développement moteur et cognitif ont été évalués avec le Bayley Scales of Infant and Toddler Development, et le développement langagier avec le MacArthur Communicative Development Inventories. Des régressions linéaires multiples ont permis d'évaluer les associations entre l'exposition et le développement. Des modèles de médiation ont été utilisés pour vérifier les effets indirects. Des termes d'interaction ont été introduits pour estimer les associations spécifiques au sexe. Résultats : 1489 dyades mère-enfant ont été incluses, parmi lesquelles 4.1% ont fait usage d'antidépresseurs. L'exposition est associée négativement avec le développement moteur (b = -0.91, IC 95% -1.73, -0.09 pour la motricité fine, b = -0.89, IC 95% -1.81, 0.02 pour la motricité globale). Aucune association n'est rapportée avec la cognition et le langage. Contrôler pour la détresse prénatale n'a que légèrement modifié ces associations. Aucun effet indirect ou différentiel selon le sexe n'a été identifié. Conclusions : Cette étude rapporte une association entre une exposition aux antidépresseurs et un développement moteur plus faible à deux ans, même après avoir contrôlé pour la détresse maternelle prénatale. La taille de l'effet demeure très petite.Background: Approximately 5.5% of pregnant women take antidepressants. Studies on prenatal exposure to antidepressants reported no association with child cognition, and inconsistent results with motor function and language development. A limitation has been the failure to adjust for prenatal maternal distress. Objectives: Assess the associations between prenatal exposure to antidepressants and child development at two years of age, while adjusting for maternal depressive symptoms and stress during pregnancy. Explore indirect effects through birth complications and consider sex-specific associations. Methods: This is an ancillary study of the 3D Study, a prospective pregnancy and birth cohort. Data on antidepressants were collected through medication logs spanning the entire pregnancy. Depressive symptoms and stress were assessed each trimester by self-reported questionnaires. Motor and cognitive development were assessed with the Bayley Scales of Infant and Toddler Development (BSID), and language development with the MacArthur Communicative Development Inventories. Multiple linear regressions were used to assess the associations between exposure and developmental outcomes. Mediation models were used to assess indirect effects. Interaction terms were introduced to assess sex-specific associations. Results: 1489 mother-child dyads were included, of whom 4.1% reported prenatal antidepressant use. Prenatal exposure was negatively associated with motor development (b = -0.91, 95% CI -1.73, -0.09 for fine motor, b = -0.89, 95% CI -1.81, 0.02 for gross motor). There were no associations with cognitive (b = -0.53, 95% CI -1.82, 0.72) and language (b = 4.13, 95% CI -3.72, 11.89) development. Adjusting for maternal prenatal distress only slightly modify these associations. No indirect effect or differential effect according to child sex were found. Conclusions: This study supports evidence of an association between prenatal exposure to antidepressants and poorer motor development at two years of age, even after adjusting for maternal distress, but the effect size remains very small, with about one BSID point lower

Antidepressants use during pregnancy and child psychomotor, cognitive and language development at 2 years of age—Results from the 3D Cohort Study

Introduction: Approximately 5.5% of pregnant women take antidepressants. Studies on prenatal exposure to antidepressants reported no association with child cognition, and inconsistent results with motor function and language development. A limitation has been the failure to adjust for prenatal maternal distress.Objectives: Assess the associations between prenatal exposure to antidepressants and child development at age two, while adjusting for maternal depressive symptoms and stress during pregnancy. Explore indirect effects through birth complications and consider sex-specific associations.Methods: This is an ancillary study of the 3D (Design Develop, Discover) Study initiated during pregnancy. Data on antidepressants were collected through medication logs spanning the entire pregnancy. Depressive symptoms and stress were assessed during pregnancy by self-reported questionnaires, motor and cognitive development with the Bayley Scales of Infant and Toddler Development (BSID-III), and language development with the MacArthur Communicative Development Inventories at age 2. Multiple linear regressions were used to assess the associations between exposure and developmental outcomes. Mediation models were used to assess indirect effects. Interaction terms were introduced to assess sex-specific associations.Results: 1,489 mother-child dyads were included, of whom 61 (4.1%) reported prenatal antidepressant use. Prenatal exposure was negatively associated with motor development (B = −0.91, 95% CI -1.73, −0.09 for fine motor, B = −0.89, 95% CI -1.81, 0.02 for gross motor), but not with cognitive (B = −0.53, 95% CI -1.82, 0.72) and language (B = 4.13, 95% CI -3.72, 11.89) development. Adjusting for maternal prenatal distress only slightly modified these associations. No indirect effect or differential effect according to child sex were found.Conclusion: This study supports evidence of a negative association between prenatal exposure to antidepressants and motor development at age two, after adjusting for maternal distress, but the effect size remains very small, with about only one BSID-III point lower in average