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Maternal SSRI exposure increases the risk of autistic offspring: A meta-analysis and systematic review

Published online by Cambridge University Press:  23 March 2020

S. Andalib ,
M.R. Emamhadi ,
S. Yousefzadeh-Chabok ,
S.K. Shakouri ,
P.F. Høilund-Carlsen ,
M.S. Vafaee  and
T.M. Michel
S. Andalib*
Affiliation:
Neuroscience Research Center, Department of Neurosurgery, Poursina Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
M.R. Emamhadi
Affiliation:
Brachial Plexus and Peripheral Nerve Injury Center, Guilan University of Medical Sciences, Rasht, Iran
S. Yousefzadeh-Chabok
Affiliation:
Neuroscience Research Center, Department of Neurosurgery, Poursina Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
S.K. Shakouri
Affiliation:
Physical Medicine and Rehabilitation Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
P.F. Høilund-Carlsen
Affiliation:
Department of Nuclear Medicine, Odense University Hospital, University of Southern Denmark, Odense, Denmark
M.S. Vafaee
Affiliation:
Department of Nuclear Medicine, Odense University Hospital, University of Southern Denmark, Odense, Denmark Department of Psychiatry, Psychiatry Region of Southern, Odense, Denmark Research Unit of Psychiatry, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark Center for Applied Neuroscience, BRIDGE, Odense University Hospital, University of Southern Denmark, Psychiatry in the Region of Southern Denmark, Odense, Denmark Neurosciences Research Center, Department of Neurology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
T.M. Michel
Affiliation:
Department of Psychiatry, Psychiatry Region of Southern, Odense, Denmark Research Unit of Psychiatry, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark Center for Applied Neuroscience, BRIDGE, Odense University Hospital, University of Southern Denmark, Psychiatry in the Region of Southern Denmark, Odense, Denmark Neurosciences Research Center, Department of Neurology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
*
*Corresponding author. Fax: +98 133 332 2444. E-mail address:[email protected] (S. Andalib).
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Abstract

Background:

Selective serotonin reuptake inhibitors (SSRIs) are the most common antidepressants used to preclude maternal pregnancy depression. There is a growing body of literature assessing the association of prenatal exposure to SSRIs with autism spectrum disorder (ASD). The present systematic review and meta-analysis reviewed the medical literature and pooled the results of the association of prenatal exposure to SSRIs with ASD.

Methods:

Published investigations in English by June 2016 with keywords of selective serotonin reuptake inhibitors, SSRI, autism spectrum disorder, ASD, pregnancy, childhood, children, neurodevelopment were identified using databases PubMed and PMC, MEDLINE, EMBASE, SCOPUS, and Google Scholar. Cochran's Q statistic-value (Q), degree of freedom (df), and I2 indices (variation in odds ratio [OR] attributable to heterogeneity) were calculated to analyze the risk of heterogeneity of the within- and between-study variability. Pooled odds ratio (OR) and 95% confidence interval (CI) were reported by a Mantel–Haenszel test.

Results:

There was a non-significant heterogeneity for the included studies ([Q = 3.61, df = 6, P = 0.730], I2 = 0%). The pooled results showed a significant association between prenatal SSRI exposure and ASD (OR = 1.82, 95% CI = 1.59–2.10, Z = 8.49, P = 0.00).

Conclusion:

The evidence from the present study suggests that prenatal exposure to SSRIs is associated with a higher risk of ASD.

Keywords

Selective serotonin reuptake inhibitorsSSRIAutism spectrum disorderASDPregnancyChildhood
Type
Review
Information
European Psychiatry , Volume 45 , September 2017 , pp. 161 - 166
Copyright
Copyright © European Psychiatric Association 2017

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Footnotes

1

Both co-authors have contributed equally.

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