Association of prenatal antidepressant use with internalizing behaviors from kindergarten to adolescence
Bibliographic record
Abstract
BACKGROUND: To examine, using repeated measures, whether prenatal serotonin/norepinephrine reuptake inhibitor (SRI) antidepressant exposure is associated with increased anxious behaviors at kindergarten age and anxiety and/or depression behaviors after kindergarten and into adolescence. METHODS: This population-based retrospective cohort study included all live singleton infants delivered in British Columbia, Canada between January 2001 and December 2012 with complete outcome data. Follow-up lasted until December 2022. Logistic regression models were used to estimate unadjusted and adjusted odds ratios (OR). To minimize confounding, high-dimensional propensity score adjustment and a matched discordant sibling-pair analysis were conducted. RESULTS: Prenatal SRI exposure was associated with increased anxious behaviors in kindergarten (OR 1.77 [95% CI 1.59-1.97]) and anxiety and/or depression diagnostic codes in later childhood or adolescence (OR 2.09 [95% CI 1.97-2.22]). These associations attenuated but remained positive after high-dimensional propensity score adjustment; however, the associations did not remain in the conditional logistic regression of discordant sibling pairs (aORs 0.92 [95% CI 0.61-1.37] and 1.02 [95% CI 0.79-1.33]). Regardless of SRI exposure, children with high levels of anxious behaviors at kindergarten were more likely to receive anxiety and/or depression diagnostic codes later on (SRI exposed: aOR 1.59 [95% CI 1.24-2.06]; SRI unexposed: aOR 1.64 [95% CI 1.51-1.77]). CONCLUSIONS: The associations of prenatal SRI exposure with increased internalizing behaviors at kindergarten and into adolescence are likely due to shared genetics or environmental factors. Findings also suggested kindergarten as a time for targeted interventions to address developmental vulnerabilities and prevent later development of anxiety and/or depression.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".