Research · April 14, 2014
TAKE-HOME MESSAGE
- In 966 mother–child pairs, including children with autism spectrum disorders (ASDs), developmental delays (DDs), and typical development (TD), boys with ASD were three times more likely than children with TD to have been prenatally exposed to selective serotonin reuptake inhibitors (SSRIs), and children with DDs were also more likely than children with TD to have been exposed.
- While further studies are required to further support the findings of this research, prenatal exposure to SSRIs may increase the risk of ASDs and DDs. Risks associated with maternal depression and mood disorders, as well as the risks and benefits of SSRI use during pregnancy, must be carefully evaluated.
Prenatal SSRI Use and Offspring With Autism Spectrum Disorder or Developmental Delay
- Rebecca A. Harrington, PhD, MPH
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 population-based 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.