SSRIs May Mitigate Negative Health Outcomes Associated With Postnatal Depression

Postnatal treatment with selective serotonin reuptake inhibitors (SSRIs) could provide long-term benefit to women suffering from postnatal depression and their offspring, according to research published in JAMA Network Open.¹

Postnatal depression affects 10% to 15% of women during the first year after childbirth and can lead to recurrent depressive episodes in subsequent pregnancies. The psychiatric disorder also affects offspring, as children born to mothers with postnatal depression exhibit higher levels of behavioral and emotional problems.

SSRI’s have long been the preferred medication to treat postnatal depression due to their better safety profiles and tolerance, but there is a lack of strong evidence about their long-term impact on women and their children.

“Adequate treatment for postnatal depression is important given its negative associations across many outcomes in mothers, children, and the wider family,” the authors of the study wrote. “However, limited evidence on the long-term consequences associated with postnatal SSRI use in offspring may be associated with treatment hesitancy."

A team of investigators from King’s College, London and the University of Oslo conducted a cohort study to examine whether postnatal SSRI treatment moderated postnatal depression–associated maternal and child outcomes across the early childhood years. Data was collected from the Norwegian Mother, Father and Child Cohort Study, which assessed the causes of diseases among mothers and children from 1999 through 2008.

The study cohort included 61081 mother-child dyads. Only women with data on depression symptoms at gestation week 30 and postpartum month 6, as well as data on self-reported medication use for mental health problems at postpartum month 6, were included.

Study outcomes included self-reported depression symptomology and relationship satisfaction from childbirth to postpartum year 5 for women, and maternal-reported internalizing and externalizing problems, attention-deficit/hyperactivity disorder symptoms, and motor and language development at ages 1.5, 3, and 5 years for children.

Investigators found that 8671 mother-child dyads met the criteria for postnatal depression, of which 177 received treatment with SSRIs. Adverse maternal and child outcomes were associated with more severe postnatal depression symptoms. In the participants who received SSRI treatment, negative associations between postnatal depression and later maternal depression, as well as partner relationship satisfaction, were mitigated.

Additionally, SSRI treatment attenuated child externalizing problems and attention-deficit/hyperactivity disorder symptoms up to 5 years after childbirth.

“Postnatal depression was associated with poorer maternal and child outcomes up to postpartum year 5,” the authors concluded. “However, associations between postnatal depression and some unfavorable outcomes were attenuated by SSRI treatment. While our findings need to be replicated, we believe that they add important information regarding long-term outcomes associated with SSRI use for postnatal maternal depression.”

Reference

1. Liu C, Ystrom E, McAdams TA. Long-Term Maternal and Child Outcomes Following Postnatal SSRI Treatment. JAMA Netw Open. 2023;6(8):e2331270. doi:10.1001/jamanetworkopen.2023.31270