A new study suggests that mothers’ use of antidepressants during the first trimester of pregnancy does not increase the chances of epilepsy and seizures in children. The research was published in the May 11, 2022 online issue of Neurology®Medical Journal of the American Academy of Neurology.
“The results of this study are very important,” said study author Ayesha Sujan, PhD, from Indiana University in Bloomington, Indiana. “Pregnancy can be a stressful time, and the addition of depression, anxiety, and other mental health conditions can add to this burden. These findings may provide reassurance to women and their physicians given the risks and benefits of the drug.”
The study looked at more than 1.7 million children born in Sweden over a 17-year period. Researchers identified more than 24,000 babies who were exposed to antidepressants during the first trimester of pregnancy and compared them to those who were not.
Antidepressants have included medications to treat anxiety and depression, specifically selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs).
The researchers then looked at hospital admissions and specialist outpatient visits to identify children who had seizures during the first month of life or epilepsy in the first years of life. Of the 1,551,906 infants who were followed up for 1 month after birth, 0.12% or 1,864 infants had neonatal epileptic seizures. Of the 1,367,087 children who were followed for 2 to 17 years, 0.40% or 5,424 children were diagnosed with epilepsy.
Although seizures are rare in the first month of life, they were more common in children exposed to SSRIs or SSRIs during pregnancy than in children who were not exposed to these antidepressants. Before adjusting for maternal-specific factors such as age, epilepsy, socioeconomic status and tobacco use, there were 1.7 per 1000 infants exposed to a neonatal seizure versus 1.2 per 1000 children not exposed to a neonatal seizure. Similarly, while 5.4 per 1,000 children with epilepsy were diagnosed by age 5, 4.1 per 1,000 children without epilepsy was diagnosed by age 5.
While the authors found a higher prevalence of seizures and neonates among exposed infants than in unexposed infants, after adjusting for factors in mothers associated with an increased risk of seizures in newborns, they found no link between maternal antidepressant use during the first trimester and risk of seizures in newborns. The child has seizures or epilepsy.
“While several studies have shown a possible link between maternal antidepressant use during pregnancy and seizures in newborns and young children, our study suggested that exposure to antidepressants in the first trimester of pregnancy does not increase the risk of seizures and epilepsy in children,” Sugan said. “. “This may mean that the slightly elevated risk of such seizures documented in previous studies may be due to other factors such as other diseases or tobacco use during pregnancy.”
The study’s limitation was that antidepressant use was based on women who reported their own use only during the first trimester of pregnancy. The authors also note that they examined exposure in the first trimester, while some previous studies have documented the strongest associations with antidepressant use and seizures or epilepsy in children at the end of pregnancy.
The study was funded by the National Institute of Neurological Disorders and Stroke, the National Institute of Mental Health, the National Institute on Drug Abuse, the National Science Foundation, the Swedish Research Council for Health, Work Life and Wellbeing and the Swedish Research Council.