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Moms' Blues Bad News for Their Kids

Studies find effects of depression trickle down

MONDAY, Feb. 2, 2004 (HealthDayNews) -- Two new studies suggest maternal depression may affect children more than had previously been realized.

The first study found that even though babies born to mothers taking medications for depression appear to develop normally physically, subtle changes in their nervous systems may occur. The authors suggest further research should be done to determine if the benefits of taking these medications truly outweigh the potential risks.

The second study discovered that mothers who were depressed were more likely to have sicker children, not enough food in the home, and to have reported losing federal benefits such as welfare.

Both papers appear in the February issue of Pediatrics.

Nearly one in 10 Americans suffers from depression every year, according to the National Institutes of Mental Health.

"Depression in and of itself can affect the neurodevelopmental status of newborns. It is certainly something we need to be concerned about," says the lead author of the first study, Philip Sanford Zeskind, director of neurodevelopmental research at Carolinas Medical Center in Charlotte, N.C.

But, he adds, doctors and parents also need to be concerned about potential side effects from selective serotonin reuptake inhibitors (SSRIs), commonly used antidepressants. Zeskind explains that past research has concluded these medications are safe to take during pregnancy because they don't cause physical developmental problems, such as low birth weight or preterm birth.

However, such measures of an infant's health are an "antiquated" way to assess the development of a baby's nervous system, he says.

"When your car isn't working well, your mechanic can open up the hood and see that all the parts are there. But if he doesn't turn it on to see how the engine runs, he's a terrible mechanic," Zeskind explains. What researchers need to do is "turn the engine on in babies" to see how well their neurobehavioral system is working to properly assess the effects of SSRI use in pregnancy.

In his study, Zeskind compared 17 babies whose mothers used SSRIs in pregnancy to 17 babies who weren't exposed to SSRIs in the womb.

Babies born to mothers who used SSRIs were more tremulous, had greater motor activity, startled more often, slept deeply for very long periods of time, had fewer changes in behavioral states, and their heart rhythms were more erratic than babies who were not exposed to SSRIs.

Zeskind says he doesn't know what the long-term effect of these changes might be, and the researchers don't know if these changes are caused by a quick withdrawal from the drug, or from serotonin syndrome, a serious condition caused by too much serotonin.

In the second study, more than 5,000 mothers from across the United States were interviewed after bringing their children either to a general clinic or an emergency department. The researchers conducted a depression screen and asked the mothers about their child's health and conditions at home.

Thirty-five percent of the mothers interviewed tested positive for depression.

"Mothers positive on a depression screening are more likely to have lost federal support [such as welfare or food stamps], be food-insecure, and consider their children in poor health," says study co-author Dr. Patrick Casey, director for the Center on Applied Research and Evaluation at Arkansas Children's Hospital in Little Rock.

Casey points out their findings suggest "that policymakers who want to move families off welfare should consider evaluations for maternal depression if they want to optimize successful outcomes." And, he says, getting treatment for depression should count towards welfare eligibility hours.

More information

To learn more about depression, visit the National Institute of Mental Health or the Depression and Bipolar Support Alliance.

SOURCES: Patrick Casey, M.D., director, Center on Applied Research and Evaluation, Arkansas Children's Hospital, and professor, pediatrics, University of Arkansas for Medical Sciences, Little Rock; Philip Sanford Zeskind, Ph.D., research professor, pediatrics, University of North Carolina, and director, neurodevelopmental research, Carolinas Medical Center, Charlotte; February 2004 Pediatrics
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