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J Am Acad Child Adolesc Psychiatry. 2016 May;55(5):359-66. doi: 10.1016/j.jaac.2016.02.013. Epub 2016 Mar 3.

Gestational Exposure to Selective Serotonin Reuptake Inhibitors and Offspring Psychiatric Disorders: A National Register-Based Study.

Author information

1
Teratology Information and Clinical Pharmacology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Department of Child Psychiatry, University of Turku, Turku, Finland. Electronic address: heli.malm@hus.fi.
2
Columbia University College of Physicians and Surgeons, New York; Columbia University Mailman School of Public Health, New York; Sackler Institute for Developmental Psychobiology, New York State Psychiatric Institute, Columbia University, New York; Division of Epidemiology, New York State Psychiatric Institute, New York.
3
Department of Child Psychiatry, University of Turku, Turku, Finland; National Institute for Health and Welfare, Helsinki, and Nordic School of Public Health, Gothenburg, Sweden.
4
Department of Child Psychiatry, University of Turku, Turku, Finland; University of Helsinki and Helsinki University Hospital and New York State Psychiatric Institute and Columbia University, New York.
5
Department of Child Psychiatry, University of Turku, Turku, Finland.
6
Columbia University Mailman School of Public Health, New York.
7
Finnish Cancer Registry, Helsinki.
8
Columbia University College of Physicians and Surgeons, New York; Sackler Institute for Developmental Psychobiology, New York State Psychiatric Institute, Columbia University, New York.
9
Department of Child Psychiatry, University of Turku, Turku, Finland; Turku University Central Hospital Turku, Finland; Columbia University College of Physicians and Surgeons, New York; Division of Epidemiology, New York State Psychiatric Institute, New York.

Abstract

OBJECTIVE:

To investigate the impact of gestational exposure to selective serotonin reuptake inhibitors (SSRIs) on offspring neurodevelopment.

METHOD:

This is a cohort study using national register data in Finland between the years 1996 and 2010. Pregnant women and their offspring were categorized into 4 groups: SSRI exposed (n = 15,729); exposed to psychiatric disorder, no antidepressants (n = 9,651); exposed to SSRIs only before pregnancy (n = 7,980); and unexposed to antidepressants and psychiatric disorders (n = 31,394). We investigated the cumulative incidence of offspring diagnoses of depression, anxiety, autism spectrum disorder (ASD), and attention-deficit/hyperactivity disorder (ADHD) for the 4 groups from birth to 14 years, adjusting for confounders.

RESULTS:

The cumulative incidence of depression among offspring exposed prenatally to SSRIs was 8.2% (95% CI = 3.1-13.3%) by age 14.9 years, compared with 1.9% (95% CI = 0.9-2.9%) in the psychiatric disorder, no medication group (adjusted hazard ratio [HR] = 1.78; 95% CI = 1.12-2.82; p = .02) and to 2.8% (95% CI = 1.4-4.3%) in the SSRI discontinued group (HR = 1.84; 95% CI = 1.14-2.97; p = .01). Rates of anxiety, ASD, and ADHD diagnoses were comparable to rates in offspring of mothers with a psychiatric disorder but no medication during pregnancy. Comparing SSRI exposed to unexposed individuals, the HRs were significantly elevated for each outcome.

CONCLUSION:

Prenatal SSRI exposure was associated with increased rates of depression diagnoses in early adolescence but not with ASD or ADHD. Until confirmed, these findings must be balanced against the substantial adverse consequences of untreated maternal depression.

KEYWORDS:

ADHD; ASD; SSRI; offspring depression; pregnancy

PMID:
27126849
PMCID:
PMC4851729
DOI:
10.1016/j.jaac.2016.02.013
[Indexed for MEDLINE]
Free PMC Article

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