Liu X, et al. – This study was designed to examine the association between in utero exposure to antidepressants and risk of psychiatric disorders. Evidence suggested that in utero exposure to antidepressants was associated with increased risk of psychiatric disorders. This association was probably caused by the severity of underlying maternal disorders in combination with antidepressant exposure in utero. Hence, focusing solely on a single psychiatric disorder among offspring in studies of in utero antidepressant exposure might be too restrictive.

Methods

• In this study, 905 383 liveborn singletons born during 1998-2012 in Denmark and followed from birth until July 2014, death, emigration, or date of first psychiatric diagnosis, whichever came first. 
• The children were followed for a maximum of 16.5 years and contributed 8.1×10⁶person years at risk.
• Children were divided into 4 groups according to maternal antidepressant use within two years before and during pregnancy: unexposed, antidepressant discontinuation (use before but not during pregnancy), antidepressant continuation (use both before and during pregnancy), and new user (use only during pregnancy).
• First psychiatric diagnosis in children, defined as first day of inpatient or outpatient treatment for psychiatric disorders. 
• With the aid of Cox regression models, hazard ratios of psychiatric disorders were estimated.

Results

• In 32 400 children, psychiatric disorders were diagnosed. 
• The adjusted 15 year cumulative incidence of psychiatric disorders was 8.0% (95% confidence interval 7.9% to 8.2%) in the unexposed group, 11.5% (10.3% to 12.9%) in the antidepressant discontinuation group, 13.6% (11.3% to 16.3%) in the continuation group, and 14.5% (10.5% to 19.8%) in the new user group.
•  The antidepressant continuation group had an increased risk of psychiatric disorders (hazard ratio 1.27, 1.17 to 1.38), compared with the discontinuation group.