Women who take antidepressants during pregnancy may be unknowingly predisposing their infants to type 2 diabetes and obesity later in life, according to new research from McMaster University.
The study finds a correlation between the use of the medication fluoxetine during pregnancy and an increased risk of obesity and diabetes in children.
Currently, up to 20 per cent of woman in the United States and approximately seven per cent of Canadian women are prescribed an antidepressant during pregnancy.
“Obesity and Type 2 diabetes in children is on the rise and there is the argument that it is related to lifestyle and availability of high calorie foods and reduced physical activity, but our study has found that maternal antidepressant use may also be a contributing factor to the obesity and diabetes epidemic,” said the study’s senior investigator Alison Holloway, associate professor of obstetrics and gynecology at McMaster University.
Previous studies have found that pregnant women are particularly vulnerable to depression and it is estimated that up to one in five pregnant women have symptoms of depression during pregnancy.
“While it is known that these drugs can increase the risk of obesity in adults, it is unknown whether a woman’s antidepressant use during pregnancy increases the risk of metabolic disturbances in her children,” Holloway says, adding the goal of their project was to determine whether maternal exposure to a commonly used antidepressant is related to the development of fatty liver, an outcome commonly seen with obesity, in the offspring.
“We have demonstrated for the first time in an animal model that maternal use of a class of antidepressants called selective serotonin reuptake inhibitors, or SSRIs, resulted in increased fat accumulation and inflammation in the liver of the adult offspring, raising new concerns about the long-term metabolic complications in children born to women who take SSRI antidepressants during pregnancy,” says PhD student Nicole De Long, who presented this research on June 22nd at the joint meeting of the International Society of Endocrinology and The Endocrine Society.
Their study does not suggest women should avoid taking antidepressants during pregnancy, only that there may be risks associated with antidepressants that haven’t been previously identified, Holloway says.
Childhood obesity can have complications for the physical, social and emotional well-being of your child.
Type 2 diabetes. Type 2 diabetes in children is a chronic condition that affects the way your child’s body metabolizes sugar (glucose). Obesity and a sedentary lifestyle increase the risk of type 2 diabetes.
Metabolic syndrome. Metabolic syndrome isn’t a disease itself, but a cluster of conditions that can put your child at risk of developing heart disease, diabetes or other health problems. This cluster of conditions includes high blood pressure, high blood sugar, High cholesterol and excess abdominal fat.
High cholesterol and high blood pressure. Your child can develop high blood pressure or High cholesterol if he or she eats a poor diet. These factors can contribute to the buildup of plaques in the arteries. These plaques can cause arteries to narrow and harden, which can lead to a heart attack or stroke later in life.
Asthma and other breathing problems. The extra weight on your child’s body can cause problems with the development and health of your child’s lungs, leading to asthma or other breathing problems.
Sleep disorders. Obstructive sleep apnea, a condition in which your child may snore or have abnormal breathing when he or she sleeps, can be a complication of childhood obesity. Pay attention to breathing problems your child may have while sleeping.
Nonalcoholic fatty liver disease (NAFLD). This disorder, which usually causes no symptoms, causes fatty deposits to build up in the liver. NAFLD can lead to scarring and liver damage.
Early puberty or menstruation. Being obese can create hormone imbalances for your child. These imbalances can cause puberty to start earlier than expected.
Social and emotional complications
Low self-esteem and bullying. Children often tease or bully their overweight peers, who suffer a loss of self-esteem and an increased risk of depression as a result.
Behavior and learning problems. Overweight children tend to have more anxiety and poorer social skills than normal-weight children have. At one extreme, these problems may lead overweight children to act out and disrupt their classrooms. At the other, they may cause overweight children to socially withdraw.
Depression. Low self-esteem can create overwhelming feelings of hopelessness in some overweight children. When children lose hope that their lives will improve, they may become depressed. A depressed child may lose interest in normal activities, sleep more than usual or cry a lot. Some depressed children hide their sadness and appear emotionally flat instead. Either way, depression is as serious in children as in adults. If you think your child is depressed, talk with him or her and share your concerns with his or her doctor.
“The benefit of the study is it may help in the identification of a high-risk group of children who may require specific interventions to prevent obesity and type 2 diabetes later in life,” she says.
The next stage of their research will be to understand the mechanistic pathways behind why these drugs pose a risk. “If we can understand how the antidepressant causes adverse metabolic outcomes in the offspring than we can design therapeutic strategies to prevent the damage while allowing women who require these drugs to be treated but reduce the potential harm to the offspring.”
Childhood Obesity and Diabetes: Two Sides of the Same Coin
Michelle Obama isn’t the only person alarmed by the epidemic of childhood obesity. So is weight-control specialist Dr. Howard Shapiro. “Kids at the age of 12 are getting adult-onset diabetes,” says Shapiro. “One-third of everybody born in 2005 will have some form of diabetes.” Shapiro’s new book, Eat & Beat Diabetes with Picture Perfect Weight Loss: The Visual Program to Prevent and Control Diabetes, written with chef Franklin Becker, is an action plan for both adults and children. TIME senior reporter Andrea Sachs met Dr. Shapiro over a healthy, veggie-laden lunch in Manhattan, where he has practiced medicine for 30 years.
Is the steep increase of diabetes in children solely a matter of obesity or does it have to do with a lack of exercise as well?
It’s the whole package. Kids are obese today because there is no phys ed in school, both parents are working, nobody is cooking a dinner at home, and [what they are eating] is fast food. Fast food is high caloric, not healthy, and portions are gigantic. Kids don’t exercise. Kids sit on the computer all day, and they don’t do anything.
Funding for this project was provided by the Canadian Institutes of Health Research (ACH). Salary support was provided by the CIHR training program in Reproduction, Early Development, and the Impact on Health.
A photo of the researchers is available at http://fhs.mcmaster.ca/media/antidepressant_use_during_pregnancy/
For further information, please contact:
Associate professor of obstetrics and gynecology
Media Relations, Faculty of Health Sciences,