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Prenatal exposure to selective serotonin reuptake inhibitors and social responsiveness symptoms of autism: population-based study of young children
Open accessAbstract
Background: Selective serotonin reuptake inhibitors (SSRIs) are considered safe and are frequently used during pregnancy. However, two case–control studies suggested an association between prenatal SSRI exposure with childhood autism. Aims: To prospectively determine whether intra-uterine SSSRI exposure is associated with childhood autistic symptoms in a population-based study. Method: A total of 376 children prenatally exposed to maternal depressive symptoms (no SSRI exposure), 69 children prenatally exposed to SSRIs and 5531 unexposed children were included. Child pervasive developmental and affective problems were assessed by parental report with the Child Behavior Checklist at ages 1.5, 3 and 6. At age 6, we assessed autistic traits using the Social Responsiveness Scale (n= 4264). Results: Prenatal exposure to maternal depressive symptoms without SSRIs was related to both pervasive developmental (odds ratio (OR) = 1.44, 95% CI 1.07–1.93) and affective problems (OR = 1.44, 95% CI 1.15–1.81). Compared with unexposed children, those prenatally exposed to SSRIs also were at higher risk for developing pervasive developmental problems (OR = 1.91, 95% CI 1.13–3.47), but not for affective problems. Children prenatally exposed to SSRIs also had more autistic traits (B= 0.15, 95% CI 0.08–0.22) compared with those exposed to depressive symptoms only. Conclusions: Our results suggest an association between prenatal SSRI exposure and autistic traits in children. Prenatal depressive symptoms without SSRI use were also associated with autistic traits, albeit this was weaker and less specific. Long-term drug safety trials are needed before evidence-based recommendations are possible.
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“Associations between ASD and maternal psychiatric conditions preceding or during pregnancy (20, 45, 46), including depression (24, 43, 44, 47), schizophrenia (48, 49), anxiety (50), and personality disorders (48), are commonly reported in the literature.”
From Maternal Psychiatric Conditions, Treatment With Selective Serotonin Reuptake Inhibitors, and Neurodevelopmental Disorders (2021) · cites this paper as [44]
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“However, reflecting the mixed evidence of this research area, our findings also contradict several other large studies conducted in Sweden,(30, 43) the Netherlands (44), California (31, 32), Canada (29), and Denmark (27, 28).”
From Maternal Psychiatric Conditions, Treatment With Selective Serotonin Reuptake Inhibitors, and Neurodevelopmental Disorders (2021) · cites this paper as [44]
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“These positive findings in other studies persisted even after efforts to reduce confounding by indication through adjustment for maternal psychiatric condition (29, 31, 43, 44), restriction to mothers with psychiatric conditions (27–30, 32), and propensity weighting methods (30).”
From Maternal Psychiatric Conditions, Treatment With Selective Serotonin Reuptake Inhibitors, and Neurodevelopmental Disorders (2021) · cites this paper as [44]
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Metadata
- Authors
- Marroun, H. E., White, T. J. H., van der Knaap, N. J. F., Homberg, J. R., Fernández, G., Schoemaker, N. K., Jaddoe, V. W. V., Hofman, A., Verhulst, F. C., Hudziak, J. J., Stricker, B. H. C., & Tiemeier, H.
- Affiliations
- Erasmus MC (NL)
- University of Vermont (US)
- Corresponding author
- Tiemeier, Henning
- ORCID
- Venue
- British Journal of Psychiatry
- Publisher
- Royal College of Psychiatrists
- Published
- 2014-08
- Volume
- 205
- Issue
- 2
- Pages
- 95-102
- ISSN
- 0007-1250 (ISSN-L)
- 1472-1465
- OpenAlex
- W1981456496
- Cited by
- 117
- References
- 54
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 1 · 2023: 9 · 2022: 3 · 2021: 7 · 2020: 13 · 2019: 11 · 2018: 16 · 2017: 15 · 2016: 18 · 2015: 11 · 2014: 3
- FWCI
- 15.52
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The British Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Pregnancy and Medication Impact
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Keywords
- prenatal SSRI exposure, selective serotonin reuptake inhibitors, autism spectrum disorder, autistic traits, social responsiveness, maternal depression, emotional problems, child behavior, drug safety in pregnancy
- MeSH terms
- Autistic Disorder, Depressive Disorder, Female, Humans, Pregnancy, Prenatal Exposure Delayed Effects, Selective Serotonin Reuptake Inhibitors
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