Examining differences in placental efficiency following exposure to antidepressants and current depression: Findings from an Australian pregnancy cohort study
- Authors: Galbally, Megan , Watson, Stuart , Spigset, Olav , Lappas, Martha , Walker, Susan , Lewis, Andrew
- Date: 2022
- Type: Text , Journal article
- Relation: Placenta Vol. 119, no. (2022), p. 44-51
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- Description: Placental dysfunction and inefficiency, is important in understanding fetal growth restriction and low birth weight. Two recent studies have examined the relationship between antidepressant use in pregnancy and placental weight ratios one found lower placental weight ratio associated with antidepressant use and the other found a higher ratio. This study examined 342 women recruited in early pregnancy, including 75 taking antidepressants, 29 with current depression and 238 controls. Antidepressant use was measured through self-report in early and late pregnancy, hospital records at delivery and drug concentrations in umbilical cord and maternal blood obtained at delivery. Maternal depression was measured using the Structured Clinical Interview for the DSM IV (SCID) at recruitment. Placentas were collected at delivery and weighed, and infant birth weight recorded. Placental efficiency was measured using standardised placental weight residuals and included as the outcome in general linear models (ANOVA/ANCOVA) to test hypotheses. While placental weight was higher for those on antidepressants compared to controls (z=.30 c.f. Z=-0.08, p=.012), there were no significant differences between the three groups after adjusting for maternal body mass index at recruitment. When comparing antidepressant groups separately there were small-to-moderate positive associations between (SSRI) concentrations and placental weight (rho's > 0.20, p's > 0.05), which did not reach significance. Antidepressant use in pregnancy was not associated with significant changes in placental efficiency after adjustment for confounding variables. Future research should expand on this to examine other aspects of placental function and include a wide range of potential confounding variables to draw clinically meaningful conclusions. •Birth weight to placental weight ratio is often used as a proxy for placental dysfunction.•Placental dysfunction may underlie the association between antenatal antidepressant use and low infant birth weight.•Two studies found the opposite relationship between antidepressants and placental weight but did not adjust for confounders.•We found placental weight, when adjusted for confounders, was not significantly different for those on antidepressants.
Antidepressant exposure in pregnancy and child sensorimotor and visuospatial development
- Authors: Galbally, Megan , Watson, Stuart , Spigset, Olav , Boyce, Philip , Oberlander, Tim , Lewis, Andrew
- Date: 2021
- Type: Text , Journal article
- Relation: Journal of psychiatric research Vol. 143, no. (2021), p. 485-491
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- Description: Motor development underlies many aspects of education and learning. There has been uncertainty about the impact of exposure of antidepressant medication in pregnancy on child motor outcomes. This paper examines whether exposure to antidepressants in utero increases the risk of poorer motor development in two areas: sensorimotor and visuospatial processing. Data were obtained from 195 women and children across 3 groups: women with untreated depression in pregnancy, women treated with antidepressants and control women. Data were collected across pregnancy, postpartum and until 4 years for mother and child. Maternal depression was established at baseline with the Structured Clinical Interview for DSM-IV. Antidepressant exposure, including type, dose and timing, was measured through repeated self-report across pregnancy and the postpartum, medical records at delivery and in cord blood samples collected at delivery. Child sensorimotor and visuospatial outcomes were assessed at 4 years of age with four subtests from the NEPSY-II. Our study found for sensorimotor development, visuomotor precision completion time was associated with better performance for antidepressant-exposed children compared to those with mothers with untreated depression. Yet another measure of sensorimotor development, motor manual sequences, was poorer in those exposed to antidepressants. One subtest for visuospatial processing, block construction, was associated with poorer performance in antidepressant-exposed children who had poor neonatal adaptation and those exposed to a higher dose of antidepressant. These findings suggest an inconsistent association between sensorimotor development and antidepressant use in pregnancy. However, the findings for visuospatial processing would support further exploration of antidepressant associated poor neonatal adaption and later motor development.
The relationship between oxytocin blood concentrations and antidepressants over pregnancy and the postpartum
- Authors: Galbally, Megan , Watson, Stuart , Keelan, Jeffrey , Spigset, Olav , Lewis, Andrew
- Date: 2021
- Type: Text , Journal article
- Relation: Progress in Neuro-Psychopharmacology and Biological Psychiatry Vol. 109, no. (2021), p. 110218-110218
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- Description: Antidepressant treatment of perinatal depression is increasingly common and accepted in clinical guidelines. It has been suggested that serotonergic antidepressants may effect changes in the oxytocinergic system, including oxytocin levels, and that this may be one of the beneficial mechanisms of action for these drugs. Furthermore, oxytocin has been associated with the quality of the parent-child relationship, which may be important in treatment of perinatal depression. This study will explore if there is a relationship between antidepressant use over the perinatal period and oxytocin levels. Data from a pregnancy cohort study are used from 279 women across three groups: women taking antidepressants in pregnancy (n = 48), women with untreated depression (n = 31) and healthy control women (n = 200). Data included antidepressant use, maternal depression and oxytocin plasma concentrations in pregnancy and up to 12 months postpartum. We found that concurrent oxytocin blood concentrations were not associated with perinatal antidepressant use. However, oxytocin blood concentrations increased more steeply in those on antidepressants across the perinatal period compared to control women. A steeper increase for Selective Serotonergic Reuptake Inhibitors was observed, however, this effect was on the boarder of statistical significance. In conclusion, although antidepressant use and oxytocin was not associated at any time point, women taking antidepressants during pregnancy had larger increases in oxytocin over the perinatal period. Future research could examine specific agents and class of antidepressant and the relationship to parenting. •Animal studies have suggested that SSRI antidepressants may be associated with increased oxytocin levels•Oxytocin levels increased for women from early pregnancy to 12 months postpartum•Differences in cross-sectional perinatal oxytocin blood concentrations were not associated with antidepressant use•Antidepressant blood concentrations and oxytocin blood concentrations were not associated•Antidepressants across pregnancy and the postpartum were assocaited with a steeper increase in levels of oxytocin