Paternal use of antidepressants and offspring outcomes in Sweden: nationwide prospective cohort study
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OBJECTIVE: To examine the association between paternal antidepressant use at conception and offspring preterm birth, malformations, autism spectrum disorder, and intellectual disability. DESIGN: Observational prospective cohort study with regression methods, and negative control comparison. SETTING: Sweden nationwide. PARTICIPANTS: 170 508 children conceived from 29 July 2005 and born in 2006-07, followed up to 2014 at age 8-9 years. This cohort included 3983 children born to fathers receiving antidepressant treatment during the conception period (that is, from four weeks before conception to four weeks after), a control group of 164 492 children not exposed to paternal antidepressant use, and a negative control comparison group of 2033 children born to fathers who did not use antidepressants during the conception period but began antidepressant treatment later during the pregnancy period (that is, from four weeks after conception to childbirth). MAIN OUTCOME MEASURE: Offspring preterm birth, malformation diagnosed at birth, diagnosis of autism spectrum disorder, and diagnosis of intellectual disability. RESULTS: Paternal antidepressant use during conception was not associated with preterm birth (adjusted odds ratio 0.91 (95% confidence interval 0.79 to 1.04)) or malformations (1.06 (0.90 to 1.26)) using logistic regression, compared with offspring born to unexposed fathers. No association was seen between antidepressant use during conception and autism (adjusted hazard ratio 1.13 (0.84 to 1.53)) or intellectual disability (0.82 (0.51 to 1.31)) using Cox regression. In children whose fathers initiated antidepressant treatment during pregnancy, results were similar for all outcomes apart from intellectual disability, which had an increased adjusted hazard ratio (1.66 (1.06 to 2.59)). Compared with the 2033 children whose fathers initiated antidepressant treatment during pregnancy, the 3983 children exposed to paternal use of antidepressants at conception had no differences in preterm birth, malformation, and autism, but a reduced risk of intellectual disability (adjusted hazard ratio 0.49 (0.26 to 0.93)). CONCLUSION: Paternal intake of antidepressants during the period around conception is safe with respect to the risk of the four major adverse outcomes in offspring-preterm birth, malformation, autism, or intellectual disability.
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Research has not found evidence that paternal SSRI use around conception increases autism risk.
“Research has not found evidence that paternal SSRI use around conception increases autism risk [131, 133, 134].”
From The contribution of environmental exposure to the etiology of autism spectrum disorder (2019) · cites this paper as [133]
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The contribution of environmental exposure to the etiology of autism spectrum disorder
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- Authors
- Viktorin, A., Levine, S. Z., Altemus, M., Reichenberg, A., & Sandin, S.
- Affiliations
- Karolinska Institutet (SE)
- University of Haifa (IL)
- Yale University (US)
- Mount Sinai Hospital (US)
- Corresponding author
- Sandin, Sven
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 2018-06-08
- Volume
- 361
- Pages
- k2233
- ISSN
- 1756-1833 (ISSN-L)
- 0959-8138
- PMC
- PMC5992520
- OpenAlex
- W2805711097
- Cited by
- 23
- References
- 51
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 4 · 2023: 1 · 2022: 3 · 2021: 1 · 2020: 4 · 2019: 2 · 2018: 2
- FWCI
- 2.14
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- BMJ (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- Funders
- Svenska Läkaresällskapet
- National Institutes of Health
- National Institute of Mental Health (MH097849, R01MH097849)
- National Institute of Child Health and Human Development
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (U01HD073978, HD073978)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Pregnancy and Medication Impact
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Substance Exposure Effects
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pharmacological Effects and Toxicity Studies
- Keywords
- conception, preterm birth, congenital malformations, autism spectrum disorder, intellectual disability, offspring outcomes, prenatal exposure, antidepressant safety
- MeSH terms
- Antidepressive Agents, Child, Depression, Fathers, Female, Fertilization, Follow-Up Studies, Humans, Infant, Newborn, Male, Pregnancy, Prenatal Exposure Delayed Effects, Prospective Studies, Sweden
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