Kids' ADHD Risk May Be Linked to Mother's Underlying Mental Health, Not Prenatal Antidepressant Use

By Kelly Young

Edited by André Sofair, MD, MPH

Prenatal antidepressant use is associated with increased risk for attention-deficit/hyperactivity disorder in offspring, but the elevated risk might not be caused by the drugs, suggests a study in The BMJ.

Using a Hong Kong database, researchers identified 190,000 mother-child pairs. Overall, 3% of the children were diagnosed with or received medication for ADHD.

Antidepressant use in pregnancy was associated with increased ADHD risk among offspring (adjusted hazard ratio, 1.4). However, risk was also elevated among children whose mothers used antidepressants before conception and among those whose mothers had psychiatric disorders but hadn't used antidepressants — suggesting that the increased risk may be at least partly explained by the mother's preexisting condition.

The authors conclude: "We propose that if a causal association exists, then the size of the effect is probably smaller than that previously reported. However, decision making about antidepressant use in pregnancy remains important and requires an assessment of the risks and benefits."