A Lupattelli1, M Mahic2, M Handal2, E Ystrom1,2,3, T Reichborn-Kjennerud2,4, H Nordeng1,5. 1. PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, and PharmaTox Strategic Research Initiative, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, 0316, Norway. 2. Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, 0213, Norway. 3. Department of Psychology, PROMENTA Research Centre, University of Oslo, Oslo, Norway. 4. Institute of Clinical Medicine, University of Oslo, Oslo, Norway. 5. Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, 0213, Norway.
Abstract
OBJECTIVE: To determine the association between child attention-deficit/hyperactivity disorder (ADHD) and prenatal exposure to selective serotonin (SSRI) and serotonin-norepinephrine (SNRI) reuptake inhibitor antidepressants, by timing and duration, with quantification of bias due to exposure misclassification. DESIGN: Norwegian Mother, Father and Child Cohort Study and national health registries. SETTING: Nationwide, Norway. POPULATION: A total of 6395 children born to women who reported depression/anxiety in pregnancy and were either medicated with SSRI/SNRI in pregnancy (n = 818) or non-medicated (n = 5228), or did not report depression/anxiety but used antidepressants 6 months before pregnancy (discontinuers, n = 349). MAIN OUTCOME MEASURE: Diagnosis of ADHD or filled prescription for ADHD medication in children, and mother-reported symptoms of ADHD by child age 5 years. RESULTS: When the hazard was averaged over the duration of the study follow up, there was no difference in ADHD risk between ever in utero SSRI/SNRI-exposed children and comparators (weighted hazard ratio [wHR] 1.07, 95% CI 0.76-1.51 versus non-medicated; wHR 1.53, 95% CI 0.77-3.07 versus discontinuers). Underestimation of effects due to exposure misclassification was modest. In early childhood, the risk for ADHD was lower with prenatal SSRI/SNRI exposure compared with no exposure, and so were ADHD symptoms (weighted β -0.23, 95% CI -0.39 to -0.08); this risk became elevated at child age 7-9 years (wHR 1.93, 95% CI 1.22-3.05). Maternal depression/anxiety before pregnancy was independently associated with child ADHD. CONCLUSION: Prenatal SSRI/SNRI exposure is unlikely to considerably increase the risk of child ADHD beyond that posed by maternal depression/anxiety. The elevated risk at child age 7-9 years needs to be elucidated. TWEETABLE ABSTRACT: Women with depression who use antidepressants in pregnancy do not have greater risk of having children with ADHD. Findings in school-age children needs follow up.
OBJECTIVE: To determine the association between childattention-deficit/hyperactivity disorder (ADHD) and prenatal exposure to selective serotonin (SSRI) and serotonin-norepinephrine (SNRI) reuptake inhibitor antidepressants, by timing and duration, with quantification of bias due to exposure misclassification. DESIGN: Norwegian Mother, Father and Child Cohort Study and national health registries. SETTING: Nationwide, Norway. POPULATION: A total of 6395 children born to women who reported depression/anxiety in pregnancy and were either medicated with SSRI/SNRI in pregnancy (n = 818) or non-medicated (n = 5228), or did not report depression/anxiety but used antidepressants 6 months before pregnancy (discontinuers, n = 349). MAIN OUTCOME MEASURE: Diagnosis of ADHD or filled prescription for ADHD medication in children, and mother-reported symptoms of ADHD by child age 5 years. RESULTS: When the hazard was averaged over the duration of the study follow up, there was no difference in ADHD risk between ever in utero SSRI/SNRI-exposed children and comparators (weighted hazard ratio [wHR] 1.07, 95% CI 0.76-1.51 versus non-medicated; wHR 1.53, 95% CI 0.77-3.07 versus discontinuers). Underestimation of effects due to exposure misclassification was modest. In early childhood, the risk for ADHD was lower with prenatal SSRI/SNRI exposure compared with no exposure, and so were ADHD symptoms (weighted β -0.23, 95% CI -0.39 to -0.08); this risk became elevated at child age 7-9 years (wHR 1.93, 95% CI 1.22-3.05). Maternal depression/anxiety before pregnancy was independently associated with childADHD. CONCLUSION: Prenatal SSRI/SNRI exposure is unlikely to considerably increase the risk of childADHD beyond that posed by maternal depression/anxiety. The elevated risk at child age 7-9 years needs to be elucidated. TWEETABLE ABSTRACT: Women with depression who use antidepressants in pregnancy do not have greater risk of having children with ADHD. Findings in school-age children needs follow up.
Authors: Elizabeth A Suarez; Brian T Bateman; Sonia Hernández-Díaz; Loreen Straub; Katherine L Wisner; Kathryn J Gray; Page B Pennell; Barry Lester; Christopher J McDougle; Yanmin Zhu; Helen Mogun; Krista F Huybrechts Journal: JAMA Intern Med Date: 2022-10-03 Impact factor: 44.409
Authors: Sarah Kittel-Schneider; Ethel Felice; Rachel Buhagiar; Mijke Lambregtse-van den Berg; Claire A Wilson; Visnja Banjac Baljak; Katarina Savic Vujovic; Branislava Medic; Ana Opankovic; Ana Fonseca; Angela Lupattelli Journal: Int J Environ Res Public Health Date: 2022-02-10 Impact factor: 3.390