Fathers' antidepressant use doesn't worsen babies' health risks

Fathers’ use of antidepressant medications around the time mothers become pregnant does not increase babies’ risk of preterm birth, birth defects, autism or intellectual disability, according to a study in the BMJ.

Study leader Sven Sandin of the Icahn School of Medicine at Mount Sinai in New York City told Reuters Health by email that while it has generally been assumed that paternal use of antidepressants holds no risk for a developing baby, this previously had not been well-studied.

The results were not “a big surprise,” he said, but are nevertheless important, since there has been extensive research into the risks of mothers taking antidepressants, but less attention paid to fathers.

“Depression and anxiety disorders are very common and many potential fathers take antidepressant medication to treat these illnesses,” he wrote. “The findings from this study are reassuring for men using antidepressant medication, showing that this does not increase risk of autism, intellectual disability or birth defects for their infants.”

Sandin and colleagues studied 170,508 Swedish children who were conceived between 2005 and 2007. The team tracked the children’s outcomes through December 31, 2014 using the Swedish Medical Birth Register and the Swedish National Patient Register. They also used the Swedish Prescribed Drug Register to identify fathers who filled prescriptions of antidepressant drugs around the time of conception and after a child was conceived, as well as fathers who did not take any antidepressants.

After controlling for factors such as paternal and maternal age and history of psychiatric disease, the researchers found that fathers’ use of antidepressant medications at conception did not increase the risk to their offspring. They did find an increased risk of intellectual disability in offspring of fathers who initiated treatment after conception, but Sandin said this may be a chance finding.

“Use after conception cannot affect the infant,” he said.

Dr. Anna Sara Oberg of the department of Medical Epidemiology & Biostatistics at the Karolinska Institutet in Sweden said she and fellow researchers published a similar analysis of the same data focused on maternal antidepressant usage in the Journal of the American Medical Association last year. She said the new findings support previous research indicating that underlying conditions and patient characteristics - rather than antidepressant medication itself - may influence the risk of neurodevelopmental disorders in children. Ideally, she said, the new study would have tracked the outcomes of children past the age of 8 or 9, since some children may not receive a diagnosis by that age.

“As a result, these findings may target the more manifest and/or severe cases,” she wrote in an email to Reuters.

Dr. Sonia Hernandez-Díaz, a professor of epidemiology at the Harvard T.H. Chan School of Public Health, said that there had been “no real concern in the scientific community about paternal exposure.” She said that, for years, studies had implied a possible connection between maternal use of antidepressants and the development of neurodevelopmental or mood disorders in children. An increasing body of evidence shows that it is likely not these medications, but, rather, the mental disorders that led the mothers to take the medications - or associated environmental or genetic factors - that increases babies’ risks for these problems.

“It is a sensitive issue and the possibility of an effect of taking medications and hurting your child has created suffering and guilt in women,” she wrote in an email to Reuters.

“We have learnt from what we have done to moms, that we need to be extra careful and thoughtful before screaming ‘wolf,’” she added. “In this sense, a negative study is important to publish and communicate because had it been ‘positive’ (i.e., found an increased risk) it would had been on the cover of the magazines.”