S Andalib1, M R Emamhadi2, S Yousefzadeh-Chabok3, S K Shakouri4, P F Høilund-Carlsen5, M S Vafaee6, T M Michel7. 1. Neuroscience Research Center, Department of Neurosurgery, Poursina Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran. Electronic address: andalib@gums.ac.ir. 2. Brachial Plexus and Peripheral Nerve Injury Center, Guilan University of Medical Sciences, Rasht, Iran. 3. Neuroscience Research Center, Department of Neurosurgery, Poursina Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran. 4. Physical Medicine and Rehabilitation Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. 5. Department of Nuclear Medicine, Odense University Hospital, University of Southern Denmark, Odense, Denmark. 6. Department of Nuclear Medicine, Odense University Hospital, University of Southern Denmark, Odense, Denmark; Department of Psychiatry, Psychiatry Region of Southern, Odense, Denmark; Research Unit of Psychiatry, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark; Center for Applied Neuroscience, BRIDGE, Odense University Hospital, University of Southern Denmark, Psychiatry in the Region of Southern Denmark, Odense, Denmark; Neurosciences Research Center, Department of Neurology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran. 7. Department of Psychiatry, Psychiatry Region of Southern, Odense, Denmark; Research Unit of Psychiatry, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark; Center for Applied Neuroscience, BRIDGE, Odense University Hospital, University of Southern Denmark, Psychiatry in the Region of Southern Denmark, Odense, Denmark; Neurosciences Research Center, Department of Neurology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
Abstract
BACKGROUND: Selective serotonin reuptake inhibitors (SSRIs) are the most common antidepressants used to preclude maternal pregnancy depression. There is a growing body of literature assessing the association of prenatal exposure to SSRIs with autism spectrum disorder (ASD). The present systematic review and meta-analysis reviewed the medical literature and pooled the results of the association of prenatal exposure to SSRIs with ASD. METHODS: Published investigations in English by June 2016 with keywords of selective serotonin reuptake inhibitors, SSRI, autism spectrum disorder, ASD, pregnancy, childhood, children, neurodevelopment were identified using databases PubMed and PMC, MEDLINE, EMBASE, SCOPUS, and Google Scholar. Cochran's Q statistic-value (Q), degree of freedom (df), and I2 indices (variation in odds ratio [OR] attributable to heterogeneity) were calculated to analyze the risk of heterogeneity of the within- and between-study variability. Pooled odds ratio (OR) and 95% confidence interval (CI) were reported by a Mantel-Haenszel test. RESULTS: There was a non-significant heterogeneity for the included studies ([Q=3.61, df=6, P=0.730], I2=0%). The pooled results showed a significant association between prenatal SSRI exposure and ASD (OR=1.82, 95% CI=1.59-2.10, Z=8.49, P=0.00). CONCLUSION: The evidence from the present study suggests that prenatal exposure to SSRIs is associated with a higher risk of ASD.
BACKGROUND: Selective serotonin reuptake inhibitors (SSRIs) are the most common antidepressants used to preclude maternal pregnancy depression. There is a growing body of literature assessing the association of prenatal exposure to SSRIs with autism spectrum disorder (ASD). The present systematic review and meta-analysis reviewed the medical literature and pooled the results of the association of prenatal exposure to SSRIs with ASD. METHODS: Published investigations in English by June 2016 with keywords of selective serotonin reuptake inhibitors, SSRI, autism spectrum disorder, ASD, pregnancy, childhood, children, neurodevelopment were identified using databases PubMed and PMC, MEDLINE, EMBASE, SCOPUS, and Google Scholar. Cochran's Q statistic-value (Q), degree of freedom (df), and I2 indices (variation in odds ratio [OR] attributable to heterogeneity) were calculated to analyze the risk of heterogeneity of the within- and between-study variability. Pooled odds ratio (OR) and 95% confidence interval (CI) were reported by a Mantel-Haenszel test. RESULTS: There was a non-significant heterogeneity for the included studies ([Q=3.61, df=6, P=0.730], I2=0%). The pooled results showed a significant association between prenatal SSRI exposure and ASD (OR=1.82, 95% CI=1.59-2.10, Z=8.49, P=0.00). CONCLUSION: The evidence from the present study suggests that prenatal exposure to SSRIs is associated with a higher risk of ASD.
Authors: Elena Dragioti; Marco Solmi; Angela Favaro; Paolo Fusar-Poli; Paola Dazzan; Trevor Thompson; Brendon Stubbs; Joseph Firth; Michele Fornaro; Dimitrios Tsartsalis; Andre F Carvalho; Eduard Vieta; Philip McGuire; Allan H Young; Jae Il Shin; Christoph U Correll; Evangelos Evangelou Journal: JAMA Psychiatry Date: 2019-12-01 Impact factor: 21.596