Maternal SSRIs experience and risk of ASD in offspring: a review

Fatima, Zainab; Zahra, Aqeela; Ghouse, Maria; Wang, Xu; Zhang, Yuan

doi:10.1039/c8tx00102b

Cited by 13 publications

(12 citation statements)

References 88 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The data are highly congruent, however, with one proposed biological mechanism of ASD development, serotonin metabolism dysfunctions, and serotonergic changes (64,65). Along the described limitations in addressing indication bias, in utero SSRI exposure may potentially intervene with the end-point diagnosis as well (66). Mechanisms which impact adults' 5-HT can last after discontinuation of treatment, and can…”

Section: The Association Between Prenatal Ssris and Autism Spectrum Dmentioning

confidence: 87%

The Association Between Prenatal Exposure to Antidepressants and Autism: Some Research and Public Health Aspects

2020

View full text Add to dashboard Cite

Use of antidepressants (ADs) in general, and in pregnant notwithstanding, has been increasing globally in recent decades. Associations with a wide range of adverse perinatal and childhood outcomes following prenatal ADs exposure have been observed in registry-based studies, with Autism Spectrum Disorders (ASD) frequently reported. Studies using animal models, sibling analyses, and negative control approaches, have linked dysfunctional serotonin metabolism with ASD, but did not convincingly tease apart the role of maternal mental health from that of ADs. As work to decipher the nature of the AD-ASD association continues, this review raises some public health concerns pertinent to a hypothetical conclusion that this association is causal, including the need to identify specific gestation periods with higher risk, the importance of precise assessment of the ASD potential prevention that might be attributed to AD discontinuation, and the estimation of risks associated with prenatal exposure to untreated depression.

show abstract

Section: The Association Between Prenatal Ssris and Autism Spectrum Dmentioning

confidence: 87%

The Association Between Prenatal Exposure to Antidepressants and Autism: Some Research and Public Health Aspects

2020

View full text Add to dashboard Cite

show abstract

“…Perinatal exposure to SSRIs is reported to negatively affect the plasticity of developing hippocampus especially in male fetus, which affects children's behavioral development [31]. In accordance, a number of recent systematic reviews and meta-analyses report that antenatal use of antidepressants (SSRIs) increases the risk of attention-deficit/ hyperactivity disorder and autism spectrum disorders [7,[32][33][34].…”

Section: The Effect Of Gestational Exposure To Antidepressants On Growing Childrenmentioning

confidence: 97%

“…As a result of such a stressed fetal neurodevelopment, these children are at a great risk of delayed cognitive and motor development as well as impaired tolerance to stressful conditions [3,4]. In the same way, postnatal depression represents a risk for non-optimal parenting behaviors, impaired mother-child interactions, child victimization, and development of childhood psychopathology [5,6].Antidepressant medications-and in particular, selective serotonin reuptake inhibitors (SSRIs)-are considered as the first line of treatment of perinatal depression [7,8]. It is estimated that 10% of pregnant women are prescribed antidepressant medications [8].…”

mentioning

confidence: 99%

See 1 more Smart Citation

The Adverse Effects of Antidepressant Medication Treatments on the Offspring of Women with Perinatal Depression

Ali

Hassan

Hendawy

2019

SJRR

View full text Add to dashboard Cite

Up to one fifth of pregnant and postpartum women are affected by depressive disorders, which imply a range of adverse consequences for both moms, their babies, and the entire family [1,2]. Untreated prenatal maternal depression is reported to induce epigenetic fetal changes that involve permanent alteration of the neuroendocrine functions of the fetus. As a result of such a stressed fetal neurodevelopment, these children are at a great risk of delayed cognitive and motor development as well as impaired tolerance to stressful conditions [3,4]. In the same way, postnatal depression represents a risk for non-optimal parenting behaviors, impaired mother-child interactions, child victimization, and development of childhood psychopathology [5,6].Antidepressant medications-and in particular, selective serotonin reuptake inhibitors (SSRIs)-are considered as the first line of treatment of perinatal depression [7,8]. It is estimated that 10% of pregnant women are prescribed antidepressant medications [8]. To achieve treatment goals, these drugs are consumed for long periods of time (at least 6-8 months) since treatment of depression

show abstract

“…Fatima et al [111] recently assessed the data only of studies reporting on a positive association between prenatal SRI exposure and ASD. The authors concluded that there is some signal of a possible association, but their conclusion is weakened by the fact that they did not include any of the “negative” studies that did not report any association.…”

Section: Possible Association With Autism Spectrum Disorder (Asd)mentioning

confidence: 99%

SSRIs and SNRIs (SRI) in Pregnancy: Effects on the Course of Pregnancy and the Offspring: How Far Are We from Having All the Answers?

Ornoy¹,

Koren

2019

IJMS

View full text Add to dashboard Cite

Serotonin has important roles in the development of the brain and other organs. Manipulations of synaptic serotonin by drugs such as serotonin reuptake inhibitors (SRI) or serotonin norepinephrine reuptake inhibitors (SNRI) might alter their development and function. Of interest, most studies on the outcome of prenatal exposure to SRI in human have not found significant embryonic or fetal damage, except for a possible, slight increase in cardiac malformations. In up to a third of newborns exposed to SRI, exposure may induce transient neonatal behavioral changes (poor neonatal adaptation) and increased rate of persistent pulmonary hypertension. Prenatal SRI may also cause slight motor delay and language impairment but these are transient. The data on the possible association of prenatal SRIs with autism spectrum disorder (ASD) are inconsistent, and seem to be related to pre-pregnancy treatment or to maternal depression. Prenatal SRIs also appear to affect the hypothalamic hypophyseal adrenal (HPA) axis inducing epigenetic changes, but the long-term consequences of these effects on humans are as yet unknown. SRIs are metabolized in the liver by several cytochrome P450 (CYP) enzymes. Faster metabolism of most SRIs in late pregnancy leads to lower maternal concentrations, and thus potentially to decreased efficacy which is more prominent in women that are rapid metabolizers. Studies suggest that the serotonin transporter SLC6A4 promoter is associated with adverse neonatal outcomes after SRI exposure. Since maternal depression may adversely affect the child’s development, one has to consider the risk of SRI discontinuation on the fetus and the child. As with any drug treatment in pregnancy, the benefits to the mother should be considered versus the possible hazards to the developing embryo/fetus.

show abstract

Maternal SSRIs experience and risk of ASD in offspring: a review

Abstract: Antidepressants are extensively used during pregnancy and associated with severe outcomes, including innate malformations, prematurity, and low birth weight, etc.

Cited by 13 publications

References 88 publications

The Association Between Prenatal Exposure to Antidepressants and Autism: Some Research and Public Health Aspects

The Association Between Prenatal Exposure to Antidepressants and Autism: Some Research and Public Health Aspects

The Adverse Effects of Antidepressant Medication Treatments on the Offspring of Women with Perinatal Depression

SSRIs and SNRIs (SRI) in Pregnancy: Effects on the Course of Pregnancy and the Offspring: How Far Are We from Having All the Answers?

Contact Info

Product

Resources

About