Hanan El Marroun1, Tonya J H White1, Noortje J F van der Knaap1, Judith R Homberg1, Guillén Fernández1, Nikita K Schoemaker1, Vincent W V Jaddoe1, Albert Hofman1, Frank C Verhulst1, James J Hudziak1, Bruno H C Stricker1, Henning Tiemeier1. 1. Hanan El Marroun, PhD, Department of Child and Adolescent Psychiatry, Sophia Children's Hospital and The Generation R Study Group, Erasmus Medical Centre, Rotterdam, The Netherlands; Tonya J. H. White, MD, PhD, Department of Child and Adolescent Psychiatry, Sophia Children's Hospital and Department of Radiology, Erasmus Medical Centre, Rotterdam, The Netherlands; Noortje J. F. van der Knaap, MSc, Judith R. Homberg, PhD, Guillén Fernández, MD, PhD, Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands; Nikita K. Schoemaker, MSc, Department of Child and Adolescent Psychiatry, Sophia Children's Hospital and The Generation R Study Group, Erasmus Medical Centre, Rotterdam, The Netherlands; Vincent W. V. Jaddoe, MD, PhD, The Generation R Study Group, Department of Epidemiology and Department of Pediatrics, Erasmus Medical Centre, Rotterdam, The Netherlands; Albert Hofman, MD, PhD, Department of Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands; Frank C. Verhulst, MD, PhD, Department of Child and Adolescent Psychiatry, Erasmus Medical Centre, Sophia Children's Hospital, Rotterdam, The Netherlands; James J. Hudziak, MD, Department of Child and Adolescent Psychiatry, Erasmus Medical Centre, Sophia Children's Hospital, Rotterdam, The Netherlands, and University of Vermont, College of Medicine, Deptartment of Psychiatry, Burlington, Vermont, USA; Bruno H. C. Stricker, MD, PhD, Department of Epidemiology, Erasmus Medical Centre, Rotterdam and Inspectorate of Healthcare, The Hague, The Netherlands; Henning Tiemeier, MD, PhD, Department of Child and Adolescent Psychiatry, Sophia Children's Hospital, Department of Epidemiology and Department of Psychiatry, Erasmus Medical Centre, Rotterdam, The Netherlands.
Abstract
BACKGROUND: Selective serotonin reuptake inhibitors (SSRIs) are considered safe and are frequently used during pregnancy. However, two case-control studies suggested an association between prenatal SSRI exposure with childhood autism. AIMS: To prospectively determine whether intra-uterine SSSRI exposure is associated with childhood autistic symptoms in a population-based study. METHOD: A total of 376 children prenatally exposed to maternal depressive symptoms (no SSRI exposure), 69 children prenatally exposed to SSRIs and 5531 unexposed children were included. Child pervasive developmental and affective problems were assessed by parental report with the Child Behavior Checklist at ages 1.5, 3 and 6. At age 6, we assessed autistic traits using the Social Responsiveness Scale (n = 4264). RESULTS: Prenatal exposure to maternal depressive symptoms without SSRIs was related to both pervasive developmental (odds ratio (OR) = 1.44, 95% CI 1.07-1.93) and affective problems (OR = 1.44, 95% CI 1.15-1.81). Compared with unexposed children, those prenatally exposed to SSRIs also were at higher risk for developing pervasive developmental problems (OR = 1.91, 95% CI 1.13-3.47), but not for affective problems. Children prenatally exposed to SSRIs also had more autistic traits (B = 0.15, 95% CI 0.08-0.22) compared with those exposed to depressive symptoms only. CONCLUSIONS: Our results suggest an association between prenatal SSRI exposure and autistic traits in children. Prenatal depressive symptoms without SSRI use were also associated with autistic traits, albeit this was weaker and less specific. Long-term drug safety trials are needed before evidence-based recommendations are possible. Royal College of Psychiatrists.
BACKGROUND: Selective serotonin reuptake inhibitors (SSRIs) are considered safe and are frequently used during pregnancy. However, two case-control studies suggested an association between prenatal SSRI exposure with childhood autism. AIMS: To prospectively determine whether intra-uterine SSSRI exposure is associated with childhood autistic symptoms in a population-based study. METHOD: A total of 376 children prenatally exposed to maternal depressive symptoms (no SSRI exposure), 69 children prenatally exposed to SSRIs and 5531 unexposed children were included. Child pervasive developmental and affective problems were assessed by parental report with the Child Behavior Checklist at ages 1.5, 3 and 6. At age 6, we assessed autistic traits using the Social Responsiveness Scale (n = 4264). RESULTS: Prenatal exposure to maternal depressive symptoms without SSRIs was related to both pervasive developmental (odds ratio (OR) = 1.44, 95% CI 1.07-1.93) and affective problems (OR = 1.44, 95% CI 1.15-1.81). Compared with unexposed children, those prenatally exposed to SSRIs also were at higher risk for developing pervasive developmental problems (OR = 1.91, 95% CI 1.13-3.47), but not for affective problems. Children prenatally exposed to SSRIs also had more autistic traits (B = 0.15, 95% CI 0.08-0.22) compared with those exposed to depressive symptoms only. CONCLUSIONS: Our results suggest an association between prenatal SSRI exposure and autistic traits in children. Prenatal depressive symptoms without SSRI use were also associated with autistic traits, albeit this was weaker and less specific. Long-term drug safety trials are needed before evidence-based recommendations are possible. Royal College of Psychiatrists.
Authors: Lauritz R Meyer; Benjamin Dexter; Cecilia Lo; Elizabeth Kenkel; Takahito Hirai; Robert D Roghair; Sarah E Haskell Journal: J Matern Fetal Neonatal Med Date: 2017-04-24
Authors: Ayesha C Sujan; Martin E Rickert; A Sara Öberg; Patrick D Quinn; Sonia Hernández-Díaz; Catarina Almqvist; Paul Lichtenstein; Henrik Larsson; Brian M D'Onofrio Journal: JAMA Date: 2017-04-18 Impact factor: 56.272
Authors: Erica L Smearman; Cassandra L Hendrix; Dominika A Winiarski; Katrina C Johnson; Alicia K Smith; Opal Y Ousley; Zachary N Stowe; D Jeffrey Newport; Patricia A Brennan Journal: Dev Psychopathol Date: 2020-02