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

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http://hdl.handle.net/10138/223956

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Malm , H , Brown , A S , Gissler , M , Gyllenberg , D , Hinkka-Yli-Salomaki , S , McKeague , I W , Weissman , M , Wickramaratne , P , Artama , M , Gingrich , J A & Sourander , A 2016 , ' Gestational Exposure to Selective Serotonin Reuptake Inhibitors and Offspring Psychiatric Disorders : A National Register-Based Study ' , Journal of the American Academy of Child and Adolescent Psychiatry , vol. 55 , no. 5 , pp. 359-366 . https://doi.org/10.1016/j.jaac.2016.02.013

Title: Gestational Exposure to Selective Serotonin Reuptake Inhibitors and Offspring Psychiatric Disorders : A National Register-Based Study
Author: Malm, Heli; Brown, Alan S.; Gissler, Mika; Gyllenberg, David; Hinkka-Yli-Salomaki, Susanna; McKeague, Ian W.; Weissman, Myrna; Wickramaratne, Priya; Artama, Miia; Gingrich, Jay A.; Sourander, Andre
Contributor: University of Helsinki, Department of Clinical Pharmacology
University of Helsinki, Clinicum
Date: 2016-05
Language: eng
Number of pages: 8
Belongs to series: Journal of the American Academy of Child and Adolescent Psychiatry
ISSN: 0890-8567
URI: http://hdl.handle.net/10138/223956
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.
Subject: SSRI
pregnancy
offspring depression
ASD
ADHD
AUTISM SPECTRUM DISORDER
ANTIDEPRESSANT USE
MATERNAL DEPRESSION
PRENATAL EXPOSURE
PREGNANCY
RISK
CHILDREN
BEHAVIORS
QUALITY
WOMEN
3124 Neurology and psychiatry
515 Psychology
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