Certain antidepressants taken by mothers during pregnancy can lead to disturbed behavior in their offspring, according to the results of a small study.

Antidepressants like Prozac or Paxil, known as selective serotonin reuptake inhibitors (SSRIs), have previously been shown not to cause birth defects, the authors explain in the medical journal Pediatrics. However, only a few studies have looked at the potential neurobehavioral effects of these medications on newborns.

Dr. Philip Sanford Zeskind and Laura E. Stephens from the Carolinas Medical Center in Charlotte, North Carolina, examined the neurobehavior of 34 newborn infants. Seventeen of the mothers used SSRIs during pregnancy, while the other 17 mothers did not.

The team measured the babies' motor activity, heart rate, behavioral state, sleeping state, startle responses, and tremors between 14 and 39 hours of age.

SSRI-exposed infants had significantly more tremors. These infants also had fewer changes in behavioral state and had fewer different behavioral states during the hour-long observation than did nonexposed infants, the authors report.

Infants of mothers who took SSRIs also had more active sleep, which was characterized by fewer contiguous periods of REM sleep that were longer-lasting and by more spontaneous startles or arousals, compared with nonexposed infants.

"The present study provides the first systematic evidence that prenatal SSRI exposure is significantly associated with a wide range of neurobehavioral outcomes among healthy, full-birthweight infants," the authors conclude.

"In all, results of the present study call into question the conclusion that SSRI use during pregnancy has little impact on the developing fetus and infant outcome," Zeskind and Stephens state.

Are these effects long-lasting? "At this point," the investigators say, "it is also unclear whether these outcomes are transient or provide the basis for subsequent neurobehavioral problems that may be detected with sensitive measures of neurobehavioral development at a later age."

SOURCE: Pediatrics, February 2004.

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