Forty percent of newborns exposed to psychiatric drugs in utero required immediate medical care after birth, compared to less than 3% of unexposed newborns.
Newborns exposed to psychiatric drugs during pregnancy have a significantly higher risk of experiencing premature birth, respiratory distress, circulatory problems, and more, according to a recent study. The study found that 40% of newborns who were exposed to psychiatric drugs in the womb needed immediate medical attention after birth, while less than 3% of unexposed newborns required similar care.
The harms included respiratory distress, circulatory distress, hypothermia, feeding problems, and lower Apgar scores, as well as preterm birth. Preterm birth was more than three times as likely in the mothers who took psychiatric drugs.
“The increasingly frequent maternal drug treatment of depression and anxiety disorders in pregnancy results in an increasing number of neonates requiring special neonatal therapy,” the researchers write.
The research was led by Sabrina Nicole Wecker and Ann Sophie Dammert at the Division of Neonatology and Pediatric Intensive Care Medicine at München Klinik Harlaching, Munich, Germany. It was published in The Journal of Maternal-Fetal & Neonatal Medicine.
Another recent study found that antiseizure/antiepileptic drugs—commonly prescribed for bipolar disorder—are linked to a large increased risk of autism, ADHD, and intellectual disability.
The current study included all newborns born at the level-III unit at the München Klinik Harlaching, Germany, between January 2018 and December 2021, whose mothers had a psychiatric diagnosis (n=69). All 69 were taking psychiatric drugs. The control group consisted of 138 randomly selected newborns from the same dates whose mothers did not have a psychiatric diagnosis and who were not on psychiatric drugs.
In total, 62.32% of the newborns exposed to the drugs had medical symptoms after birth, with 40.58% requiring immediate medical care. For newborns not exposed to the drugs, 16.67% showed symptoms, and only 2.9% required medical care. Almost all newborns who required medical care after exposure to psychiatric drugs showed symptoms within 24 hours of birth.
Of those newborns who required medical therapy, 65% had to be separated from their mothers and admitted to a neonatal ward.
Newborns exposed to psychiatric drugs were also far more likely to experience multiple symptoms (33.33% versus 5.07%).
Because prematurely born infants are more likely to have these problems than non-premature infants, the researchers also analyzed their data taking this into account. It did not change their outcomes.
The study included four types of drug exposures during pregnancy: antidepressants (n=39), antipsychotics (n=5), antiepileptic drugs (n=15), and multiple medications (n=10). The majority of mothers were taking antidepressants, with the two most common being citalopram (Celexa) or sertraline (Zoloft).
The researchers compared these groups to determine if any of them caused worse issues (or if any did not cause these issues). However, they found similar symptoms and a similar need for immediate medical care no matter what type of drug the mother took during pregnancy.
The researchers write that previous studies have found that exposure to multiple medications increases the risk of adverse outcomes, but the current study didn’t find this to be true. However, they note that only 10 newborns were exposed to polypharmacy in this study, so they may not have had the statistical power to find an effect.
This particular study was also not able to account for potential confounding factors, such as the impact of the maternal psychiatric diagnosis (confounding by indication). However, previous studies that accounted for this factor have still found the drugs to be responsible, even going so far as to find untreated depression having a beneficial effect in some areas.
Ultimately, despite the massive increase in newborn health problems after exposure to psychiatric drugs, the researchers in the current study don’t suggest anything either way about the wisdom of psychiatric drug use during pregnancy. Instead, they simply recommend that doctors monitor newborns after birth.
They write, “We recommend continuous postnatal monitoring using pulse oximetry for 24 h and control of vital signs every 3 h. If symptoms occur, monitoring is continued until finally symptom-free for 24 h. In asymptomatic neonates, monitoring can be terminated after 24 h.”
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Wecker, S. N., Dammert, A. S., Scholz, C., Krüger, M., Hauer, J., & Brickmann, C. (2024). Neonatal therapy after maternal central neurotropic drug exposure—A retrospective cohort study. The Journal of Maternal-Fetal & Neonatal Medicine, 37(1), 2356038. DOI: 10.1080/14767058.2024.2356038 (Link)