Cancer
Childhood cancers in relation to maternal depression and use of antidepressants Julia Heck* Julia Heck Yu-Hsuan Chuang Ya-Hui Hu Onyebuchi A. Arah Beate Ritz Pei-Chen Lee
Background: Depression is one of the most common mood disorders in the general population, including in pregnant women. Severe maternal stress, such as bereavement, has been associated with increased childhood risks of non-Hodgkin lymphoma and hepatic and testicular cancers. Also, pregnancy intake of antidepressants was previously linked to child’s neuroblastoma. This study examined whether maternal depression and use of antidepressants could be related to pediatric cancers.
Methods: This cohort study included all children born in Taiwan from 2004-2014 (N=1,995,184). We linked the Taiwan Maternal and Child Health Database, the Cancer Registry, and the Taiwan National Health Insurance database, including the Pharmaceutical Register. From these sources, we obtained depression diagnoses (using International Classification of Disease-9 coding) and antidepressant pharmaceutical use [via Anatomical Therapeutic Chemical (ATC) codes]. We used Cox proportional-hazard regressions to quantify the joint associations of maternal depression before or during pregnancy and the filling of antidepressant prescriptions (from 9 months before pregnancy until birth) with childhood cancers.
Results: Depression and/or antidepressant prescription use were related to a possible increase in retinoblastoma (HR=1.61, 95% CI 0.81-3.17) but showed small or no associations with pediatric cancers: acute lymphoblastic leukemia (HR=0.97, 95% CI 0.64-1.45), acute myeloid leukemia (HR=1.01 (0.46-2.22), non-Hodgkin lymphoma (HR=1.05, 95% CI 0.66-1.66), central nervous system tumors (HR=1.18, 95% CI 0.68-2.05), neuroblastoma (HR=1.07, 95% CI 0.58-1.97), hepatoblastoma (HR=1.23, 95% CI 0.54-2.83), and germ cell tumors (HR=1.07, 95% CI 0.55-2.10).
Conclusions: We found little to no compelling evidence of associations between maternal depression or its treatment and pediatric cancers in offspring, which should be a reassuring finding for pregnant women.