Use of antidepressants during pregnancy and risk of attention-deficit/ hyperactivity disorder in the offspring

OBJECTIVE:: Little is known about the impact of in utero exposure to antidepressants on children's long-term mental health. This study analyzed the impact of exposure to antidepressants during pregnancy on the risk of attention-deficit/hyperactivity disorder (ADHD) in the offspring. METHODS:: Claims-based data from 38,074 families were used to identify deliveries, parental mental health diagnoses, maternal exposure to antidepressants, and diagnosis or treatment for ADHD in the children. Multiple logistic regressions were performed using the presence of ADHD in the child by the age of 5 years as the dependent variable. RESULTS:: A diagnosis of ADHD in the mother or the father was associated with higher rates of ADHD in the children (OR = 4.15, p <.001 and OR = 3.54, p <.001, respectively). A diagnosis of bipolar disorder (OR = 5.08, p <.001), psychotic disorders (OR = 4.05, p =.02), or depressive disorders (OR = 2.58, p <.001) in the mother, but not in the father, increased the risk of ADHD in their children. Exposure to bupropion during pregnancy (OR = 3.63, p =.02), especially during the second trimester (OR = 14.66, p <.001), was strongly associated with increased risk of ADHD, whereas exposure to selective serotonin reuptake inhibitors was not (OR = 0.91, p =.74). CONCLUSION:: Children of mothers treated with bupropion during pregnancy have an increased risk of being diagnosed with ADHD; a possible causal effect needs to be further studied. Assessing the mental health of caregivers should be considered as part of the evaluation and treatment of children with ADHD.