TOPLINE:

Among infants prenatally exposed to selective serotonin reuptake inhibitors (SSRI), those who were also exposed to SSRI while being breastfed showed no reduction in child cognitive performance scores compared with breastfed infants who were not postnatally exposed, a new cohort study showed.

METHODOLOGY:

• The study included nearly 100 mother-child pairs from the MotherToBaby California cohort (1989-2008). All mothers (mean age at delivery, 34 years; 87% non-Hispanic White individuals; 8% Hispanic or Latina individuals; 4% individuals from other racial groups) were treated with SSRI in pregnancy (mean duration, 24 weeks). At the age of 4-5 years, their children completed Wechsler Preschool and Primary Scale of Intelligence (WPPSI) tests.
• The children (54% girls) were categorized as those with SSRI exposure through breastfeeding (23%), those breastfed without postnatal SSRI exposure (38%), and those not breastfed (39%).
• The primary outcomes were full-scale, verbal, and performance intelligence quotient (IQ) scores, measured using the WPPSI.

TAKEAWAY:

• Adjusted mean verbal IQ scores were similar across all three exposure groups.
• Children exposed to SSRI through breastfeeding had adjusted mean full-scale IQ scores similar to those of breastfed children without postnatal SSRI exposure (109 and 106, respectively) but higher than those of children who were not breastfed (103, P = .046).
• Children exposed to SSRI through breastfeeding had a significant 8-point higher adjusted mean performance IQ score than those who were not breastfed (P = .03), but their scores did not differ significantly from those of breastfed children without postnatal SSRI exposure.

IN PRACTICE:

“Based on these results, as well as other studies in the field, we conclude that mothers in need of treatment with SSRI post-partum may be encouraged to breastfeed without discontinuation of the treatment,” the investigators wrote.

SOURCE:

The study was led by Essi Whaites Heinonen, MD, PhD, Karolinska Institutet, Huddinge, Sweden. It was published online on November 21 in JAMA Network Open.

LIMITATIONS:

Some participants were excluded from the study due to missing data on medication exposure during breastfeeding and the postpartum period. Maternal depressive symptoms during pregnancy were measured retrospectively. Additionally, the cohort may not have been representative of the general population.

DISCLOSURES:

The study was funded by the Swedish Research Council, Söderström Königska Foundation, Erik and Edith Fernström Foundation, Swedish Doctors Association, Karolinska Institutet Funds, and the State of California. Two of the four investigators reported receiving research funding from various sources outside the submitted work, which are fully listed in the original article.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.