Prenatal antidepressant exposure and child motor development: a meta-analysis

CONTEXT: There is increasing use of antidepressants in pregnancy and hence children exposed in utero. Contradictory studies exist in the literature in which researchers report on the potential impact of antenatal antidepressant exposure on subsequent child motor development. OBJECTIVE: Our objective in this systematic review and meta-analysis was to determine whether antenatal antidepressant exposure increases the risk of impaired motor development in children. DATA SOURCES: We searched PsychINFO, Embase, Medline, PubMed, and Scopus up to July 24, 2017. STUDY SELECTION: English-language cohort and case control studies in which researchers report primary data from a motor assessment of infants or children after any antidepressant exposure in pregnancy were included. DATA EXTRACTION: Of the 329 studies identified, there were 160 articles screened, 24 were included in the systematic review, and 18 met inclusion criteria for the meta-analysis. RESULTS: The total pooled results were based on random effects models and revealed a significant association between exposure to antidepressants during pregnancy and overall occurrence of poorer motor outcomes in children (effect size = 0.22; 95% confidence interval = 0.07 to 0.37) with a moderate degree of heterogeneity (I2 = 56.6%). LIMITATIONS: There was variation in the measurement both of exposure and motor development across the identified study, and few followed up to later childhood or beyond. CONCLUSIONS: A small increased risk of poorer motor development may exist for children who are exposed to antidepressant medications during pregnancy. However, the marked methodological variation among studies and the limited control for possible confounds warrants cautious interpretation of these findings.