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
Open accessAbstract
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.
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The first meta-analysis of observational studies by Man et al. described a significantly increased risk of ASD in children exposed in utero to SSRIs.
“which has resulted in the first meta-analysis of observational studies by Man et al. describing a significantly increased risk of ASD in children exposed in utero to SSRIs [15].”
The meta-analysis by Man et al. showing maternal SSRI exposure during pregnancy associated with significantly increased risk of ASD vs all unexposed women was successfully replicated.
“The meta-analysis by Man et al. demonstrating that maternal SSRI exposure during pregnancy was associated with a significantly increased risk of ASD in children vs. all unexposed women was successfully replicated (Additional file 2: Figure S1) [15].”
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- Authors
- Man, K. K. C., Tong, H. H. Y., Wong, L. Y. L., Chan, E. W., Simonoff, E., & Wong, I. C. K.
- Affiliations
- University of Hong Kong (HK)
- Macao Polytechnic University (MO)
- King's College London (GB)
- UCL School of Pharmacy (GB)
- Corresponding author
- Wong, Ian C.K.
- Venue
- Neuroscience & Biobehavioral Reviews
- Publisher
- Elsevier BV
- Published
- 2015-02
- Volume
- 49
- Pages
- 82-89
- ISSN
- 0149-7634 (ISSN-L)
- OpenAlex
- W2039857111
- Cited by
- 126
- References
- 24
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 2 · 2023: 3 · 2022: 5 · 2021: 10 · 2020: 14 · 2019: 12 · 2018: 16 · 2017: 24 · 2016: 26 · 2015: 8
- FWCI
- 3.01
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Licence
- Locations
- Neuroscience & Biobehavioral Reviews (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- The HKU Scholars Hub (University of Hong Kong) (submittedVersion, cc-by-nc-nd)
- Research Portal (King's College London) (submittedVersion)
- Funders
- Innovative Medicines Initiative
- National Institute for Health Research
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Pregnancy and Medication Impact
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Keywords
- selective serotonin reuptake inhibitors, maternal antidepressant exposure, pregnancy, autism spectrum disorder, children, prenatal drug exposure, autism risk, causality
- MeSH terms
- Child, Child Development Disorders, Pervasive, Female, Humans, Pregnancy, Prenatal Exposure Delayed Effects, Risk, Selective Serotonin Reuptake Inhibitors, Observational Studies as Topic
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