Length of prenatal exposure to selective serotonin reuptake inhibitor (SSRI) antidepressants: effects on neonatal adaptation and psychomotor development

Casper, Regina C.; Gilles, Allyson; Fleisher, Barry E.; Baran, Joan; Enns, Gregory M.; Lazzeroni, Laura C.

doi:10.1007/s00213-011-2270-z

Cited by 100 publications

(118 citation statements)

References 47 publications

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“…31,36,37 Limitations in this literature include small samples and insufficient control for maternal mental health. Furthermore, whether observed differences predict persistent impairment is unknown.…”

Section: Discussionmentioning

confidence: 99%

Prenatal SSRI Use and Offspring With Autism Spectrum Disorder or Developmental Delay

et al. 2014

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WHAT'S KNOWN ON THIS SUBJECT: Serotonin is critical in early brain development, creating concerns regarding prenatal exposure to factors influencing serotonin levels, like selective serotonin reuptake inhibitors (SSRIs). Prenatal SSRI use was recently associated with autism; however, its association with other developmental delays is unclear. WHAT THIS STUDY ADDS:This population-based case-control study in young children provides evidence that prenatal SSRI use may be a risk factor for autism and other developmental delays. However, underlying depression and its genetic underpinnings may be a confounder.abstract OBJECTIVE: To examine associations between prenatal use of selective serotonin reuptake inhibitors (SSRIs) and the odds of autism spectrum disorders (ASDs) and other developmental delays (DDs).METHODS: A total of 966 mother-child pairs were evaluated (492 ASD, 154 DD, 320 typical development [TD]) from the Childhood Autism Risks from Genetics and the Environment (CHARGE) Study, a populationbased case-control study. Standardized measures confirmed developmental status. Interviews with biological mothers ascertained prenatal SSRI use, maternal mental health history, and sociodemographic information. RESULTS:Overall, prevalence of prenatal SSRI exposure was lowest in TD children (3.4%) but did not differ significantly from ASD (5.9%) or DD (5.2%) children. Among boys, prenatal SSRI exposure was nearly 3 times as likely in children with ASD relative to TD (adjusted odds ratio [OR]: 2.91; 95% confidence interval [CI]: 1.07-7.93); the strongest association occurred with first-trimester exposure (OR: 3.22; 95% CI: 1.17-8.84). Exposure was also elevated among boys with DD (OR: 3.39; 95% CI: 0.98-11.75) and was strongest in the third trimester (OR: 4.98; 95% CI: 1.20-20.62). Findings were similar among mothers with an anxiety or mood disorder history. CONCLUSIONS:In boys, prenatal exposure to SSRIs may increase susceptibility to ASD or DD. Findings from published studies on SSRIs and ASD continues to be inconsistent. Potential recall bias and residual confounding by indication are concerns. Larger samples are needed to replicate DD results. Because maternal depression itself carries risks for the fetus, the benefits of prenatal SSRI use should be carefully weighed against potential harms.

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Section: Discussionmentioning

confidence: 99%

Prenatal SSRI Use and Offspring With Autism Spectrum Disorder or Developmental Delay

et al. 2014

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“…T he need to manage maternal depression during pregnancy has been well established, yet conflicting evidence regarding the developmental consequences of use of serotonin reuptake inhibitor antidepressants (SRIs) during pregnancy (1,2) continues to cause uncertainty about how to manage antenatal maternal mood disturbances while minimizing the risks associated with exposure to maternal depression. Up to 20% of mothers experience antenatal depression and anxiety disorders and 5-8% of infants are born with in utero exposure to SRIs (3).…”

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confidence: 99%

Prenatal exposure to serotonin reuptake inhibitor antidepressants and childhood behavior

2015

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Background: Animal research has suggested that prenatal serotonin reuptake inhibitor (SRI) antidepressant exposure causes increased anxiety-like behaviors in adulthood. We examined whether in utero SRI exposure influenced externalizing and internalizing behaviors in children at 3 y and again at 6 y of age. Methods: We recruited women in their second trimester of pregnancy from primary maternity care providers in Vancouver British Columbia, Canada. We compared the internalizing, externalizing, and the anxious and attention subscales of the internalizing behaviors scores of children exposed to SRIs and children not exposed to SRIs at age 3 and age 6. results: We included 110 mother-child pairs (44 exposed to SRI and 66 not exposed). Higher levels of internalizing and anxious behaviors were reported in SRI exposed children at both 3 and 6 y of age compared with children who were not exposed (F = 7.52, P = 0.0072 and F = 7.91, P = 0.0058, respectively). The fully adjusted hierarchical regression models indicated a positive and significant relationship between SRI exposure and increased internalizing and anxious behaviors even when controlling for maternal mood during pregnancy, postpartum and childhood. conclusion: SRI exposure was associated with sustained higher levels of internalizing behaviors in early childhood even when controlling for maternal depression.

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“…SSRIs An increased prevalence of reduced gestational age at birth following SSRI exposure was reported in seven studies investigating SSRI exposed cohorts [19][20][21][22][23][24] . SSRI exposure was also associated with a higher prevalence of preterm birth in five identified studies 20,[24][25][26][27] .…”

Section: Gestational Age At Birthmentioning

confidence: 99%

“…SSRI exposure was also associated with a higher prevalence of preterm birth in five identified studies 20,[24][25][26][27] . Not all, however, confirmed such an association, with seven studies failing to replicate an association [28][29][30][31][32][33][34] .…”

Section: Gestational Age At Birthmentioning

confidence: 99%

“…The study by Oberlander et al 22 employed a large record linkage design (n = 1575 early exposed and 1925 later exposed), with prospective ascertainment of information through medical records and found an association between length of SSRI exposure and gestational age at birth. Several studies reported that continuous or later gestational exposure was associated with reduced gestational age 20,22 and led to higher rates of preterm birth 24 . One study that investigated the effect of dose of SSRI concluded that only higher than average doses were associated with premature delivery and reduced gestational age 24 , however the slightly larger study by Hendrick et al 29 failed to find an association.…”

Section: Gestational Age At Birthmentioning

confidence: 99%

See 1 more Smart Citation

Fetal Effects of Selective Serotonin Reuptake Inhibitor Treatment During Pregnancy: Immediate and Longer Term Child Outcomes

Bromley

Wieck²,

Makarova

et al. 2012

Fet. Matern. Med. Rev.

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Length of prenatal exposure to selective serotonin reuptake inhibitor (SSRI) antidepressants: effects on neonatal adaptation and psychomotor development

Cited by 100 publications

References 47 publications

Prenatal SSRI Use and Offspring With Autism Spectrum Disorder or Developmental Delay

Prenatal SSRI Use and Offspring With Autism Spectrum Disorder or Developmental Delay

Prenatal exposure to serotonin reuptake inhibitor antidepressants and childhood behavior

Fetal Effects of Selective Serotonin Reuptake Inhibitor Treatment During Pregnancy: Immediate and Longer Term Child Outcomes

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