A systematic review of maternal antidepressant use in pregnancy and short- and long-term offspring's outcomes

Stephanie L Prady, Inna Hanlon, Lorna K Fraser, Antonina Mikocka-Walus

Research output: Contribution to journalReview articlepeer-review


The relative safety of antidepressants during pregnancy has received substantial attention, but most syntheses fail to account for mental illness effects. We aimed to evaluate the literature comparing low birth weight (LBW) and neurodevelopmental and neurobehavioural outcomes for children whose mothers took antidepressants in pregnancy compared to those whose mothers had common mental disorders, or symptoms, but who did not take antidepressants during pregnancy. A systematic review was conducted searching PubMed, MEDLINE, PsycINFO and Embase in January 2015. A modified version of the Newcastle Ottawa Scale was used to assess study quality. Eleven cohort studies were included: four reporting a LBW outcome (all with higher risk of bias) and seven reporting a neurodevelopmental outcome (five with higher risk of bias). We found only limited evidence of gestational age-adjusted LBW in exposed children in two studies which had a higher risk of bias and did not control for depressive symptom severity. Only five (7.5%) neurodevelopmental outcomes and one (12.5%) neurobehavioural outcome showed evidence of a statistically significant effect, three out of four were from studies with a higher risk of bias. There is little robust evidence indicating a detrimental effect of antidepressant use during pregnancy on LBW and neurodevelopmental and neurobehavioural outcomes. More rigorous study designs are needed.

Original languageEnglish
Pages (from-to)127-140
Number of pages14
JournalArchives of womens mental health
Issue number2
Early online date12 Oct 2017
Publication statusPublished - Apr 2018

Bibliographical note

© The Author(s) 2017


  • Journal Article
  • Review
  • Pregnancy
  • Antidepressants
  • Low birth weight
  • Neurodevelopment
  • Neurobehaviour
  • Infant, Low Birth Weight
  • Pregnancy Complications/drug therapy
  • Humans
  • Child, Preschool
  • Infant
  • Depression/complications
  • Antidepressive Agents/adverse effects
  • Prenatal Exposure Delayed Effects/chemically induced
  • Neurodevelopmental Disorders/chemically induced
  • Female
  • Child
  • Infant, Newborn

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