Prenatal exposure to antidepressants and language competence at age three: results from a large population-based pregnancy cohort in Norway

BJOG. 2014 Dec;121(13):1621-31. doi: 10.1111/1471-0528.12821. Epub 2014 Apr 14.


Objective: To examine the association between maternal use of selective serotonin reuptake inhibitors (SSRI) in pregnancy and language competence in their children at age three taking into account maternal symptoms of anxiety and depression.

Design: Population-based prospective pregnancy cohort study.

Setting: The Norwegian Mother and Child Cohort Study; recruited pregnant women from 1999 through 2008.

Population: 45,266 women with 51,748 singleton pregnancies.

Methods: The association between short- or long-term use of SSRI during pregnancy and language competence in the child was investigated using multinomial logistic regression with three outcome categories: long, complicated sentences, fairly complete sentences and language delay.

Main outcome measures: Children's language competence at age three measured by maternal report on a validated language grammar scale.

Results: Women reported use of SSRI in 386 (0.7%) pregnancies. Of these, 161 (42%) reported long-term use. Compared with children whose mothers took no SSRI, using the best language category as the reference, adjusted relative risk ratios (RRR) of having fairly complete sentences were 1.21 (95% CI 0.85-1.72) and 2.28 (1.54-3.38) for short- and long-term SSRI use, respectively. The adjusted RRRs of language delay were 0.86 (0.42-1.76) and 2.30 (1.21-4.37). Symptoms of anxiety and depression in pregnancy were independently related to language delay, adjusted RRR 1.25 (1.03-1.50) and 1.83 (1.40-2.40) for short- and long-term symptoms, respectively.

Conclusions: Prolonged use of SSRI during pregnancy was associated with lower language competence in children by age three independently of depression. Having symptoms of depression throughout pregnancy had an independent effect.

Keywords: Children; MoBa; SSRI exposure; depression; language competence; pregnancy.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antidepressive Agents / therapeutic use*
  • Anxiety / psychology
  • Child, Preschool
  • Cohort Studies
  • Depression / psychology
  • Depressive Disorder / drug therapy*
  • Depressive Disorder / psychology
  • Female
  • Humans
  • Language Development Disorders / epidemiology*
  • Language Development*
  • Logistic Models
  • Norway / epidemiology
  • Pregnancy
  • Pregnancy Complications / drug therapy*
  • Pregnancy Complications / psychology
  • Prenatal Exposure Delayed Effects / epidemiology*
  • Prospective Studies
  • Selective Serotonin Reuptake Inhibitors / therapeutic use*
  • Young Adult


  • Antidepressive Agents
  • Serotonin Uptake Inhibitors