Dépression et traitement antidépresseur pendant la grossesse : quels effets à long terme sur le sommeil de l'enfant ?

Depression is a frequent pathology in women, particularly during pregnancy, a period of psychic vulnerability. Numerous studies have shown that this disorder can have major consequences for the mother but also for the child to be born. A study of sleep in these children with the observation from the age of two to 24 weeks shows the presence of an increase in the sleep latency and in the time awake during the night, and a reduction in the sleep duration. Meanwhile, it is well-known that maternal depression, and even more major depression during pregnancy, is a risk factor for depression in children and adolescents, classically associated with specific sleep alterations. Thus, the following question arises: are the sleep alterations a consequence of the mood disorder in the mother, or are they the classical parallel of the depressive state in the child or adolescent himself? From our recent results and the rare data in the literature, it seems that maternal depression is a risk factor, in the child, of sleep disorders that change with age. They consist essentially, for children in a reduction of paradoxical sleep, and for adolescents in a decrease of total sleep time and of sleep efficiency. Given the negative effects of depression on the mother as well as on the child, it seems of primary importance to treat this pathology during pregnancy, and to propose a treatment with minimal deleterious effects on the child to be born. In this respect, the exposure to SSRI during the third trimester of pregnancy is a matter of concern, even so more when considering the results of animal research. Indeed, neonatal SSRI exposure in rodents induces sleep and behavior disorders that persist throughout life. Thus, there is a need to explore further the long-term effects of in utero exposure to SSRI on the child, and notably on its life-long vulnerability to sleep and mood disorders. Finally, on the basis of experimental data, new treatments can be developed, that aim at protecting the baby from the negative effects of the SSRI, while preserving the therapeutic efficacy in the mother.