title: Exposure to selective serotonin reuptake inhibitors during pregnancy and risk of autism spectrum disorder in children: a systematic review and meta-analysis of observational studies.
abstract: This study is a critical analysis of the association between selective serotonin reuptake inhibitors (SSRIs) exposure during pregnancy and autism spectrum disorder (ASD) risk in children. Electronic databases were searched for observational studies published from January 1946 to June 2014 related to the association between SSRI exposure during pregnancy and ASD in children. Studies relevant to the association between SSRI exposure during pregnancy and ASD in children were extracted and compiled for meta-analysis evaluation. Ninety-five citations were identified and seven observational studies were included. Four case-control studies were eligible for the meta-analysis and two cohort studies were narratively reviewed. The pooled crude and adjusted odds ratios of the case-control studies were 2.13 (95% CI 1.66-2.73) and 1.81 (95% CI 1.47-2.24) respectively. Low heterogeneity was observed between studies. The two population-based cohort studies, utilizing the same Denmark data set, have conflicting results. The findings of this meta-analysis and narrative review support an increased risk of ASD in children of mothers exposed to SSRIs during pregnancy; however, the causality remains to be confirmed.
authors.affiliation: Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, 2/F Laboratory Block, 21 Sassoon Road, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region.
authors.forename: Kenneth K C
authors.initials: KK
authors.lastname: Man
authors.affiliation: School of Health Sciences, Rua de Luís Gonzaga Gomes, Macao Polytechnic Institute, Macao; Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, 2/F Laboratory Block, 21 Sassoon Road, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region.
authors.forename: Henry H Y
authors.initials: HH
authors.lastname: Tong
authors.affiliation: Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, 2/F Laboratory Block, 21 Sassoon Road, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region.
authors.forename: Lisa Y L
authors.initials: LY
authors.lastname: Wong
authors.affiliation: Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, 2/F Laboratory Block, 21 Sassoon Road, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region.
authors.forename: Esther W
authors.initials: EW
authors.lastname: Chan
authors.affiliation: Kings College London, Institute of Psychiatry and NIHR Biomedical Research Centre for Mental Health, De Crespigny Park, London SE5 8AF, United Kingdom.
authors.forename: Emily
authors.initials: E
authors.lastname: Simonoff
authors.affiliation: Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, 2/F Laboratory Block, 21 Sassoon Road, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region; University College London, School of Pharmacy, 29-39 Brunswick Square, London WC1N 1AX, United Kingdom. Electronic address: wongick@hku.hk.
authors.forename: Ian C K
authors.initials: IC
authors.lastname: Wong
mesh_terms: D002648:Child; D002659:Child Development Disorders, Pervasive / Q000453:epidemiology*; D005260:Female; D006801:Humans; D064887:Observational Studies as Topic; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D012306:Risk; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D017367:Selective Serotonin Reuptake Inhibitors
keywords: Autism spectrum disorder; Pregnancy; SSRI; Serotonin reuptake inhibitor