# Maternal exposure to antidepressants and psychiatric outcomes among offspring in a national birth cohort.

> **NIH NIH R01** · NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC · 2021 · $481,864

## Abstract

We seek to leverage the resources of a large national birth cohort to address essential, novel questions
aimed at providing guidance to clinicians on the management of depression during pregnancy. Advances in
our knowledge of the safety of selective serotonin reuptake inhibitors (SSRIs) during pregnancy is critical to
population health. In the U.S., approximately 6% of pregnant women use SSRIs, amounting to over 200,000
births per year of exposed offspring. Since serotonin (5-HT) plays a key role in early brain development,
manipulation of 5-HT levels during this period can have lasting behavioral consequences. In a large national
birth cohort in Finland, followed to age 14, we demonstrated that maternal SSRI exposure is associated with
an increased risk of offspring depression and other adverse psychiatric outcomes independent of maternal
diagnosis. However, there are many significant gaps in our understanding of the long-term effects of maternal
SSRIs and offspring psychiatric disorders. The study has several strengths including the well-characterized
birth cohort, a large sample size, and the capacity to link maternal SSRI use to offspring psychiatric outcomes
spanning more than 2 decades.
 The main aim of the present study is to address novel questions on maternal SSRI exposure and
offspring psychiatric outcomes, including depressive and anxiety disorders, autism spectrum disorders, and
attention deficit hyperactivity disorder. For this purpose, we will use a prospective birth cohort study design
and investigate the incidence of psychiatric outcomes up to age 21 in offspring exposed and unexposed to
SSRIs in utero and capitalize on registry linkages of comprehensive nationwide databases on maternal
antidepressant use, offspring psychiatric outcomes, research assessments, and other relevant variables.
These data can be acquired in virtually all Finnish residents, who are entitled to universal health insurance.
Specifically, we shall: 1) examine whether the sharp rise in risk of depression previously observed among
maternal SSRI-exposed offspring in early adolescence continues into older age groups; 2) assess, using a
research-based interview, whether offspring depression related to prenatal SSRI exposure is more severe than
in offspring of unexposed mothers; 3) disambiguate from maternal SSRI use the contributions of maternal
illness severity, familial loading, and postnatal maternal psychopathology on offspring psychiatric outcomes; 4)
address vulnerability factors for offspring outcomes following maternal SSRI exposure, including gestational
timing of exposure, antidepressant characteristics, and offspring sex; and 5) evaluate whether neonatal
complications from SSRI withdrawal mediates associations between SSRIs and offspring outcomes. The
findings of this study, in concert with research from other groups, are expected to provide information—which
is insufficient at present—to help clinicians and patients make more informed decisions on the...

## Key facts

- **NIH application ID:** 10053685
- **Project number:** 5R01MH118247-03
- **Recipient organization:** NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC
- **Principal Investigator:** Alan Stewart Brown
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $481,864
- **Award type:** 5
- **Project period:** 2018-12-17 → 2022-10-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10053685

## Citation

> US National Institutes of Health, RePORTER application 10053685, Maternal exposure to antidepressants and psychiatric outcomes among offspring in a national birth cohort. (5R01MH118247-03). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10053685. Licensed CC0.

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