Links between serotonin reuptake inhibition during pregnancy and neurodevelopmental delay/spectrum disorders: A systematic review of epidemiological and physiological evidence.
OBJECTIVE
To investigate possible linkages between neurodevelopmental delay and neurodevelopmental spectrum disorders and exposure to medication with effects on serotonin reuptake inhibition during pregnancy.


METHODS
We systematically reviewed the epidemiological literature for studies bearing on this relationship in children born with neurodevelopmental spectrum disorder and related conditions, as well as animal studies giving serotonin reuptake inhibitors to pregnant animals and in addition reviewed the literature for proposals as to possible mechanisms that might link effects on serotonin reuptake with cognitive changes post-partum.The epidemiological studies were analysed to produce Forest plots to illustrate possible relations.


RESULTS
The odds ratio of Autistic Spectrum or related Disorders in children born to women taking serotonin reuptake inhibiting antidepressants during pregnancy in case control studies was 1.95 (95% C.I. 1.63, 2.34) and in prospective cohort studies was 1.96 (95% C.I. 1.33, 2.90).


CONCLUSIONS
There appears to be a link between serotonin reuptake inhibition in pregnancy and developmental delay and spectrum disorders in infancy leading to cognitive difficulties in childhood. More work needs to be done to establish more precisely the nature of the difficulties and possible mechanisms through which this link might be mediated.
North Wales Department of Psychological Medicine, Bangor University, Wales, UK.
D
D
Healy
North Wales Department of Psychological Medicine, Bangor University, Wales, UK.
J
J
Le Noury
David Braley Nancy Gordon Chair in Family Medicine, Department of Family Medicine, McMaster University, Hamilton, ON, Canada.
D
D
Mangin
D000818:Animals; D000928:Antidepressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D016022:Case-Control Studies; D002659:Child Development Disorders, Pervasive / Q000139:chemically induced*; D003866:Depressive Disorder / Q000188:drug therapy*; D005260:Female; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*; D011297:Prenatal Exposure Delayed Effects; D011446:Prospective Studies; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use
D000928:Antidepressive Agents; D017367:Selective Serotonin Reuptake Inhibitors
Autism spectrum disorder; antidepressants; neurodevelopmental delay; neurodevelopmental spectrum disorders; pregnancy; serotonin reuptake inhibitors