丹麦奥胡斯大学Julie Werenberg Dreier团队研究了母亲孕期抗抑郁药处方与丹麦学龄儿童标准化测试分数的相关性。相关论文于2021年11月2日发表在《美国医学会杂志》上。

人们担心产前接触抗抑郁药物会对后代神经发育造成长期影响。

为了评估母亲在怀孕期间服用抗抑郁药物处方是否与丹麦学龄儿童标准化测试成绩相关，研究组对1997年1月1日至2009年12月31日期间在丹麦出生、就读公立小学和初中的儿童进行了一项基于人群的回顾性队列研究。这些儿童在2010年1月1日至2018年12月31日期间完成了作为丹麦国家测试计划一部分的语言或数学测试。

合格学龄儿童的年龄范围为7至17岁。主要观察指标为在数学和语言测试（1-100；分数越高成绩越好）中，使用线性回归模型对母亲孕期服用和未服用抗抑郁药的儿童的标准化分数差异进行估计，并对相关混杂因素进行了校正。共进行了10项敏感性分析，包括兄弟姐妹对照分析。

研究组共纳入575369名儿童，51.1%为男性，10198名（1.8%） 儿童的母亲在怀孕期间曾服用过抗抑郁药物。测试时儿童的平均年龄从2年级的8.9岁到8年级的14.9岁不等。母亲孕期服用抗抑郁药组的儿童平均数学成绩为52.1分，显著低于母亲未服用抗抑郁药组的儿童（57.4分）；母亲孕期服用或未服用抗抑郁药组的儿童平均语言成绩分别为53.4分和56.6分，组间差异不显著。在兄弟姐妹对照分析中，经校正后两组儿童的平均数学成绩分别为53.5分和59.0分，语言成绩分别为53.9分和56.6分。

在这项针对丹麦公立学校儿童的研究中，母亲在怀孕期间开过抗抑郁药处方的儿童与未开过抗抑郁药处方的儿童相比，其数学标准化考试分数低2分，这一差异具有统计学意义，但在语言测试成绩上没有显著差异。

附：英文原文

Title: Association of Maternal Antidepressant Prescription During Pregnancy With Standardized Test Scores of Danish School-aged Children

Author: Jakob Christensen, Betina B. Trabjerg, Yuelian Sun, Julie Werenberg Dreier

Issue&Volume: 2021/11/02

Abstract:

Importance  Concerns exist about long-term neurodevelopmental consequences of prenatal exposure to antidepressants.

Objective  To evaluate whether maternal prescription fill for antidepressants in pregnancy was associated with performance in standardized tests among Danish schoolchildren.

Design, Setting, and Participants  Population-based retrospective cohort study of children born in Denmark between January 1, 1997, and December 31, 2009, attending public primary and lower secondary school. The children included had completed a language or mathematics test as part of the Danish National Test Program between January 1, 2010, and December 31, 2018. The age range of the eligible schoolchildren was 7 to 17 years.

Exposures  Maternal prescription fill for antidepressants during pregnancy, obtained from the Danish Prescription Register.

Main Outcomes and Measures  The difference in standardized scores between children with and without maternal prescription fill for antidepressants in mathematics and language tests (scale, 1-100; higher scores indicate better test results) was estimated using linear regression models, adjusted for relevant confounders. Ten sensitivity analyses were performed, including a sibling-controlled analysis.

Results  Among the 575369 children included (51.1% males), 10198 (1.8%) were born to mothers filling an antidepressant prescription during pregnancy. The mean (SD) age of children at the time of testing spanned from 8.9 (0.4) years in grade 2 to 14.9 (0.4) years in grade 8. Maternal prescription fill for antidepressants was significantly associated with a poorer performance in mathematics (mean test scores for the group exposed to maternal antidepressant fill: 52.1 [95% CI, 51.7-52.6] and for the group not exposed to maternal antidepressant fill: 57.4 [95% CI, 57.3-57.4]; adjusted difference, 2.2 [95% CI, 2.7 to 1.6]), but not in language (mean test scores for the exposed group: 53.4 [95% CI, 53.1-53.7] and for the not exposed group: 56.6 [95% CI, 56.5-56.6]; adjusted difference, 0.1 [95% CI, 0.6 to 0.3]). In the sibling-controlled analysis, the adjusted difference in mathematics (mean scores for the exposed group: 53.5 [95% CI, 52.7-54.3] and for the not exposed group: 59.0 [95% CI, 58.9-59.1]) was 2.8 (95% CI, 4.5 to 1.2) and in language (mean test scores for the exposed group: 53.9 [95% CI, 53.2-54.6] and for the not exposed group: 56.6 [95% CI, 56.5-56.7]) was 0.3 (95% CI, 1.9 to 1.2).

Conclusions and Relevance  In this study of public schoolchildren in Denmark, children whose mothers had filled prescriptions for antidepressants during pregnancy, compared with children whose mothers did not fill prescriptions for antidepressants during pregnancy, had a 2-point lower standardized test score in mathematics, a difference that was statistically significant, but had no significant difference in language test scores. The magnitude of the difference in the mathematics test score was small and of uncertain clinical importance, and the findings must be weighed against the benefits of treating maternal depression during pregnancy.

DOI: 10.1001/jama.2021.17380

Source: https://jamanetwork.com/journals/jama/article-abstract/2785717