Children whose mothers had depression around pregnancy were more likely to have special education needs than the general population, a new study from Wales reported this week. And those born to mothers taking an antidepressant had an even greater chance of developing special education needs.
The researchers could not determine whether the medication itself explained the higher risk or whether it reflected more severe depression, which would make women likelier to be prescribed antidepressants, said Saraid McIlvride, a research associate at the University of Glasgow who led the study.
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McIlvride and her colleagues linked health and education records for more than 160,000 Welsh children born between 2009 and 2016 and followed them through 2022, when the children were, on average, just under 6 years old.
Researchers estimated that 20% of children whose mothers did not have depression nor took an antidepressant had special educational needs. That figure rose to 23.6% among the roughly 12,600 children whose mothers had depression during pregnancy but were not prescribed an antidepressant and 26.5% among the roughly 7,000 children whose mothers had depression and took an antidepressant.
The findings add to a growing body of research linking maternal depression with developmental, learning and behavioral difficulties in children as depression and treatment become more common. The Centers for Disease Control and Prevention (CDC) reported that 16% of women and girls 12 or older struggled with depression in 2021-2023, up from about 11% in 2013-2014. The American College of Obstetricians & Gynecologists (ACOG) estimates that depression affects 1 in 10 pregnant women.
Depression linked to child development difficulties
Previous research has linked maternal depression with childhood developmental challenges.
An analysis published earlier this year following more than 76,000 children in Europe found associations between depression during pregnancy and emotional, behavioral, ADHD- and autism-related symptoms. A separate 2025 review of 12 studies found that children had 52% higher odds of an autism diagnosis when their mothers experienced depression before pregnancy, 48% higher odds with depression during pregnancy and 70% higher odds with depression after birth.
While these findings raise concerns, the studies — including the new research from Wales — were observational, meaning they can identify links but cannot establish that maternal depression caused the developmental difficulties. Shared genetics, family circumstances and other factors could help explain the associations.
READ MORE: Are more children developing autism, or are doctors diagnosing it differently?
Researchers have proposed several biological explanations for how depression during pregnancy might contribute to developmental difficulties in children. Changes in stress hormones or increased inflammation could affect the placenta and a baby’s developing brain, some scientists have hypothesized; however, they have not definitively established whether these changes explain the links to autism or ADHD.
The role of antidepressants
Researchers have also not established whether antidepressants taken during pregnancy cause developmental difficulties in children, or whether the associations reflect underlying depression and shared genetic or family factors.
Earlier this year, researchers from China, Canada, Germany and the U.S. combined data from 37 existing studies and compared outcomes from 649,000 pregnancies in which mothers took antidepressants and nearly 25 million pregnancies in which mothers did not.
The pooled results linked antidepressant use with a 13% higher risk of developmental disorders overall, including a 35% higher risk of ADHD and a 69% higher risk of autism. But the associations with ADHD and autism weakened or were no longer statistically significant after researchers accounted for underlying mental illness and shared family and genetic factors.
The review found no increased risk of intellectual disability, motor disorders or speech and language disorders; however, the researchers rated the certainty of their evidence as low to very low.
Animal experiments offer clues about possible biological effects. A 2024 study found that giving pregnant mice fluoxetine, commonly sold as Prozac, during pregnancy and nursing altered communication between brain cells and impaired performance on a memory task in female offspring. These findings suggest the drug can affect developing brain circuits, but again they did not establish that antidepressants cause autism or ADHD in children.
Untreated depression also carries risks
Leaving depression untreated also carries risks. Severe depression can make it harder for pregnant women to eat well, sleep and attend prenatal appointments. Depression during pregnancy has also been linked to premature birth and low birth weight, according to ACOG.
McIlvride and her colleagues cautioned against stopping treatment.
“Our results don’t suggest that women should automatically stop taking their antidepressants because depression can harm both mother and baby if not treated,” the researchers said in a press release. “Women should always speak to their doctor about what is best in their situation.”
ACOG recommends against withholding or stopping mental health medications solely because a patient is pregnant or breastfeeding. Its guidelines recommend talk therapy as an initial treatment for mild to moderate depression, with medication decisions made individually, weighing the potential risks of treatment against those of untreated illness.
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