Association between antidepressant drug use during pregnancy and child healthcare utilisation

ObjectiveTo evaluate healthcare utilisation by children who were exposed to antidepressant drug use during pregnancy and those whose mothers stopped using antidepressants before pregnancy compared with a control group.DesignCohort study.SettingHealth insurance records in the Netherlands.PopulationA total of 38 602 children born between 2000 and 2005.MethodsSurvey of child healthcare utilisation in relation to gestational antidepressant use.Main outcome measureHealthcare utilisation rates during the first year of life, with special emphasis to medical care related to cardiac disease.ResultsChildren of mothers who used antidepressants during pregnancy showed increased healthcare use during the first year of life, independent of the mother's healthcare use. The relative risk of more than two visits to general practitioners was 1.5 (95% confidence interval, CI: 1.3-1.8) in the continuous antidepressant users group and 1.3 (95% CI: 1.2-1.5) in the group of children whose mothers stopped taking medication. In both study groups there was a trend towards more drug use for infections and inflammation compared with the control group. Children continuously exposed to antidepressants had an increased risk of cardiac interventions such as cardiovascular surgery or heart catheterisation, relative risk of 5.6 (95% CI: 1.8-17.4). The risk of physiotherapy was twice as high in the antidepressant group compared with the control group (relative risk 2.0; 95% CI: 1.5-2.6).ConclusionAntidepressant use during pregnancy is associated with increased child healthcare utilisation and increased risk of major cardiac interventions in early childhood.