A Danish study has found that children born to women with untreated depression during pregnancy have increased risk for asthma, whereas, prenatal exposure to most antidepressants does not further increase the risk.
Xiaoqin Liu, a Medical Doctor, from the Section for Epidemiology, Department of Public Health, Aarhus University, Denmark, and Department of Epidemiology and Social Science on Reproductive Health, Shanghai Institute of Planned Parenthood Research, China, and his colleagues, wrote an article stating that, “antidepressants used during pregnancy in general did not increase the risk of asthma in the offspring among women with depression, with the exception of the use of older antidepressants. These findings were reported by the authors in an article published online March 9 in Pediatrics.
Furthermore, past research suggested that maternal depression could increase the risk for asthma in offspring, while other studies have also linked in utero antidepressant exposure to pulmonary diseases in the offspring and to fetal growth restriction, a risk factor for asthma. Whether or not fetal exposure to antidepressants increases asthma risk, however, remains unclear, note the authors.
Dr. Liu and colleagues used Danish national registers to identify all live singleton infants born between the years 1996 and 2007. They used International Classification of Diseases, 10th Revision, codes to identify mothers diagnosed with depression, and prescription data to find those who received antidepressants 1 year before or during pregnancy. In addition, they used prescription data and hospitalization records to identify children diagnosed with asthma after 3 years of age.
The researchers analyzed data from 733,685 children, of whom, 84,683 have been diagnosed of asthma, 21,371 born to mothers with maternal depression, and 8895 had mothers who used antidepressants during the pregnancy stage.
Moreover, results suggested a 25% increased risk for asthma in children whose mothers had prenatal depression (hazard ratio [HR], 1.25; 95% confidence interval [CI], 1.20 – 1.30), as well as a 25% increased risk for asthma among children whose mothers used antidepressants during pregnancy (95% CI, 1.18 – 1.33) in comparison with the children of mothers without depression. Children exposed to prenatal antidepressants did not have increased risk for asthma compared with children of mothers with untreated prenatal depression (HR, 1.00; 95% CI, 0.93 – 1.08).
Antidepressants were also analyzed by type; older antidepressants were associated with an increased risk for asthma, but selective serotonin reuptake inhibitors and newer antidepressants were not (HRs, 1.26 [95% CI, 1.02 – 1.55], 0.95 [95% CI, 0.88 – 1.03]; and 1.11 [95% CI, 0.89 – 1.39], respectively). Tricyclic antidepressants (TCAs) were associated with a 28% increased risk for childhood asthma (HR, 1.28; 95% CI, 1.06 – 1.56).
Fathers of children who happened to suffer depression or have used antidepressants also contributed to the increased risk for asthma in their children (HR, 1.11 [95% CI, 1.06 – 1.16]; HR, 1.12 [95% CI, 1.06 – 1.18], respectively). Paternal antidepressant type did not affect asthma risk (selective serotonin reuptake inhibitors: HR, 1.01 [95% CI, 0.91 – 1.12]; newer antidepressants: HR, 0.98 [95% CI, 0.83 – 1.16]; and older antidepressants: HR, 1.09 [95% CI, 0.93 – 1.29]).
The authors note several study limitations, including confounding that was not accounted for. In addition, TCAs are often used to treat more severe depression, they note, so women prescribed TCAs during pregnancy could have a more severe form of the disorder.
“Maternal antidepressant used during pregnancy did not increase the risk of asthma except for the use of older antidepressants,” Dr. Liu and colleagues conclude. “This finding could reflect confounding by the severity of maternal depression.”