Autism spectrum disorder and prenatal exposure to selective serotonin reuptake inhibitors: A systematic review and meta-analysis

Kobayashi, Toshimitsu; Matsuyama, Tasuku; Takeuchi, Masanobu; Itô, Shinya

doi:10.1016/j.reprotox.2016.07.016

Cited by 73 publications

(62 citation statements)

References 26 publications

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“…Kobayashi et al [38] quantitatively reviewed five case-control and three cohort studies of maternal selective serotonin reuptake inhibitor (SSRI) use in pregnancy and the risk of ASD in the offspring. They found a 50% increase in risk of ASD of mothers who took SSRIs during pregnancy; the estimate was imprecise but consistent.…”

Section: Resultsmentioning

confidence: 99%

Environmental risk factors for autism: an evidence-based review of systematic reviews and meta-analyses

2017

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BackgroundAccording to recent evidence, up to 40–50% of variance in autism spectrum disorder (ASD) liability might be determined by environmental factors. In the present paper, we conducted a review of systematic reviews and meta-analyses of environmental risk factors for ASD. We assessed each review for quality of evidence and provided a brief overview of putative mechanisms of environmental risk factors for ASD.FindingsCurrent evidence suggests that several environmental factors including vaccination, maternal smoking, thimerosal exposure, and most likely assisted reproductive technologies are unrelated to risk of ASD. On the contrary, advanced parental age is associated with higher risk of ASD. Birth complications that are associated with trauma or ischemia and hypoxia have also shown strong links to ASD, whereas other pregnancy-related factors such as maternal obesity, maternal diabetes, and caesarian section have shown a less strong (but significant) association with risk of ASD. The reviews on nutritional elements have been inconclusive about the detrimental effects of deficiency in folic acid and omega 3, but vitamin D seems to be deficient in patients with ASD. The studies on toxic elements have been largely limited by their design, but there is enough evidence for the association between some heavy metals (most important inorganic mercury and lead) and ASD that warrants further investigation. Mechanisms of the association between environmental factors and ASD are debated but might include non-causative association (including confounding), gene-related effect, oxidative stress, inflammation, hypoxia/ischemia, endocrine disruption, neurotransmitter alterations, and interference with signaling pathways.ConclusionsCompared to genetic studies of ASD, studies of environmental risk factors are in their infancy and have significant methodological limitations. Future studies of ASD risk factors would benefit from a developmental psychopathology approach, prospective design, precise exposure measurement, reliable timing of exposure in relation to critical developmental periods and should take into account the dynamic interplay between gene and environment by using genetically informed designs.Electronic supplementary materialThe online version of this article (doi:10.1186/s13229-017-0121-4) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Environmental risk factors for autism: an evidence-based review of systematic reviews and meta-analyses

2017

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“…A systematic review and meta‐analysis of seven case–control studies and four cohort studies found an increased risk of ASD in the SSRI‐exposed group . However, in these studies, maternal psychiatric illnesses were major confounding factors preventing a conclusive inference from being made.…”

Section: Prenatal Medication Exposurementioning

confidence: 99%

Autism spectrum disorder: Trends in research exploring etiopathogenesis

Gyawali

Patra

2019

Psychiatry Clin Neurosci

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Autism spectrum disorder is a neurodevelopmental condition in which affected individuals have difficulties while interacting and communicating socially, and repetitive behaviors. It has a multifactorial etiology. Various risk factors, including genetic and environmental influences, have been explored while trying to understand its causation. As older evidence was suggestive of a high heritability, a majority of research focused on finding the underlying genetic causes of autism. Due to these efforts, there have been advances in the knowledge of some of the genetic factors associated with autism. But a recent trend also shows an increasing interest in exploration of various potential environmental triggers. These efforts have brought us closer to understanding the elusive disorder more so than ever before. The current review discusses the recent trends in research exploring the etiopathogenesis of autism spectrum disorder.

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“…As a result, attempts have been made to reconcile the disagreements through meta-analysis. During approximately the last year, at least 6 important meta-analyses have examined the question [9][10][11][12][13][14] ; 2 of the meta-analyses, 9,10 in fact, were published in the same journal within a few months of each other.…”

Section: Does Antidepressant Exposure During Pregnancy Increase the Rmentioning

confidence: 99%

“…Whereas 5 of the meta-analyses [9][10][11][12][13] suggested that confounding by indication (explained below) cannot be ruled out, the sixth and among the most recent meta-analysis 14 asserted that there is…”

Section: Does Antidepressant Exposure During Pregnancy Increase the Rmentioning

confidence: 99%

“…However, the broad inference that can reasonably be drawn from the findings summarized above, and the conclusion that was endorsed by 5 of the 6 meta-analyses, [9][10][11][12][13] is that maternal mental illness is a confound that may drive the increased risk. The only dissenting meta-analysis 14 was the one that only examined overall risks without considering risks in subgroups (characterized by maternal mental illness) or specific exposure periods (preconception).…”

mentioning

confidence: 99%

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Antidepressant Exposure During Pregnancy and Risk of Autism in the Offspring, 1: Meta-Review of Meta-Analyses

Andrade¹

2017

J. Clin. Psychiatry

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Autism spectrum disorder and prenatal exposure to selective serotonin reuptake inhibitors: A systematic review and meta-analysis

Cited by 73 publications

References 26 publications

Environmental risk factors for autism: an evidence-based review of systematic reviews and meta-analyses

Environmental risk factors for autism: an evidence-based review of systematic reviews and meta-analyses

Autism spectrum disorder: Trends in research exploring etiopathogenesis

Antidepressant Exposure During Pregnancy and Risk of Autism in the Offspring, 1: Meta-Review of Meta-Analyses

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