‘Is Prozac going to affect my baby’s development?’

We will discuss “Prenatal exposure to antidepressants and language competence at age three: results from a large population-based pregnancy cohort in Norway” by Skurtveit and co-workers from 28 January 2015 for 7 days.

*This paper will be made free-to-view on 19 January 2015.

Start date: 28 January 2015 (the discussion will open for 7 days)

First hosted discussion session(s) starts at: BST 7pm (UK time)

Host: @BlueJCHost

Platforms: Twitter

The Blue Journal Club is an international journal club on women’s health research based on Twitter (as @BlueJCHost). We start our conversation on the last Wednesday of every month and use the hashtag #BlueJC for our tweets. Simply add this hashtag (“#BlueJC”) to each tweet and we will capture it. Each #BlueJC opens for 7 days with an advertised start time. All BJOG #BlueJC papers also have complementary slide sets suitable for face-to-face journal clubs with your local colleagues. You can access the slide set of this paper here (data S1).

The discussion points are attached below (quoted from the published manuscript)

Scenario

A 35-year-old nulliparous woman with depression consulted you for pre-conception advice. Her depression had been well-controlled by fluoxetine (Prozac), a selective serotonin reuptake inhibitor, for over 5 years. She had no other medical conditions. She asked, ‘Is Prozac going to affect my baby’s development?’

Description of research

Participants Norwegian women who were pregnant between 1999 and 2008
Intervention Self-reported use of selective serotonin reuptake inhibitors (SSRIs) during pregnancy
Comparison No reported use of SSRIs during pregnancy
Outcomes Language competence of their children at age three by maternal evaluation on a language grammar rating scale
Study design Population-based prospective cohort study

Discussion Points

  • Are you aware of other published studies addressing a similar clinical question?
  • Critically appraise and comment on this paper using the Critical Appraisal Skills Programme (CASP) checklist for cohort studies (http://bit.ly/1e0eF1n).
  • How was the use of SSRIs ascertained in this study? How could you reduce any potential bias from using this method?
  • How does language competence at three years correlate with long-term linguistic performance?
  • What are the advantages and disadvantages of using language competence by maternal evaluation at 3 years as the primary outcome measure?
  • Were the patient reported outcome measures (PROMs) used in this study chosen appropriately? (See PROM group, Oxford University: http://phi.uhce.ox.ac.uk/inst_selcrit.php)
  • Can you briefly summarise the results of this study? How would the results of this study influence your practice? (Data S1)

Suggested reading

Hviid A, Melbye M, Pasternak B. Use of selective serotonin reuptake inhibitors during pregnancy and risk of autism. N Engl J Med. 2013 Dec 19;369:2406–15.

For those who want to understand hashtags, this may be a useful guide. For an introduction to #BlueJC, please refer to BJOG 2013;120:657–60. Follow @BlueJCHostthis blog and our Facebook page to receive news about #BlueJC.