title: Autism spectrum disorder and prenatal exposure to selective serotonin reuptake inhibitors: A systematic review and meta-analysis.
abstract: To obtain the risk estimates of autism spectrum disorder (ASD) in the offspring exposed to serotonin reuptake inhibitors (SSRI) in utero, we performed systematic review and meta-analysis of relevant studies. Five case-control and three cohort studies were eligible for the analysis. The SSRI group had significantly higher risk of ASD than the SSRI non-exposed group (pooled OR 1.45, 95% CI 1.15-1.82). In the subgroup analyses, however, the risk of ASD was similar between the SSRI group and other antidepressants group (pooled OR 1.14, 95% CI 0.67-1.96). Furthermore, when the analysis was confined to those born to the women with psychiatric disorders, the SSRI group did not show an increased ASD risk (pooled OR 0.96, 95% CI 0.57-1.63) compared to non-exposed groups. In conclusion, SSRI use in pregnancy is associated with an increased risk of ASD in the offspring, but maternal psychiatric condition is a major confounding factor.
authors.affiliation: Division of Clinical Pharmacology and Toxicology, The Hospital for Sick Children, Canada; Division of Research Planning, Department of Development Strategy, Center for Clinical Research and Development, National Center for Child Health and Development, Japan.
authors.forename: Tohru
authors.initials: T
authors.lastname: Kobayashi
authors.affiliation: Division of Clinical Pharmacology and Toxicology, The Hospital for Sick Children, Canada; Department of Emergency Medicine, Kyoto Prefectural University of Medicine, Japan.
authors.forename: Tasuku
authors.initials: T
authors.lastname: Matsuyama
authors.affiliation: Division of Clinical Pharmacology and Toxicology, The Hospital for Sick Children, Canada.
authors.forename: Masanobu
authors.initials: M
authors.lastname: Takeuchi
authors.affiliation: Division of Clinical Pharmacology and Toxicology, The Hospital for Sick Children, Canada; Motherisk Program, The Hospital for Sick Children, Canada. Electronic address: shinya.ito@sickkids.ca.
authors.forename: Shinya
authors.initials: S
authors.lastname: Ito
mesh_terms: D000928:Antidepressive Agents / Q000627:therapeutic use*; D000067877:Autism Spectrum Disorder / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008431:Maternal-Fetal Exchange; D011247:Pregnancy; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*
chemical_list: D000928:Antidepressive Agents; D017367:Selective Serotonin Reuptake Inhibitors
keywords: Autism spectrum disorder; Child; Meta-analysis; Prenatal exposure delayed effect; Serotonin reuptake inhibitors