Prenatal Antidepressant Exposures and Autism Spectrum Disorder or Traits: A Retrospective, Multi-Cohort Study

Patricia A Brennan¹, Anne L Dunlop², Lisa A Croen³, Lyndsay A Avalos³, Amy L Salisbury⁴, Alison E Hipwell⁵, Sara S Nozadi⁶, Sheela Sathyanarayana^{7

8}, Rosa M Crum^{9

10}, Rashelle Musci¹⁰, Mingyi Li⁹, Xiuhong Li⁹, Maxwell Mansolf¹¹, Thomas G O'Connor¹², Amy J Elliott¹³, Nidhi Ghildayal¹⁴, Pi-I D Lin¹⁴, Jenna L N Sprowles¹⁵, Joseph B Stanford¹⁶, Casper Bendixsen¹⁷, Sally Ozonoff¹⁸, Barry M Lester^{19

20

21}, Coral L Shuster²¹, Kathi C Huddleston²², Jonathan Posner²³, Nigel Paneth²⁴

Affiliations

¹ Psychology Department, Emory University, 36 Eagle Row, 30322, Atlanta, GA, USA. pbren01@emory.edu.
² Department of Gynecology & Obstetrics, Emory University School of Medicine, Atlanta, GA, USA.
³ Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
⁴ Virginia Commonwealth University School of Nursing, Richmond, VA, USA.
⁵ Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA.
⁶ Health Sciences Center University of New Mexico, Albuquerque, NM, USA.
⁷ Seattle Children's Research Institute, Seattle, WA, USA.
⁸ University of Washington, Seattle, WA, USA.
⁹ Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
¹⁰ Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
¹¹ Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
¹² Departments of Psychiatry, Psychology, Neuroscience, and Obstetrics and Gynecology, University of Rochester, Rochester, NY, USA.
¹³ Avera Research Institute, Dept of Pediatrics, University of South Dakota School of Medicine, Vermillion, SD, USA.
¹⁴ Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Boston, MA, USA.
¹⁵ Beckman Institute for Advanced Science and Technology, University of Illinois Urbana- Champaign, ICF, Urbana, Durham, IL, NC, USA.
¹⁶ Department of Family and Preventive Medicine, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT, USA.
¹⁷ Marshfield Clinic Research Institute, Marshfield Clinic Health System, Marshfield, WI, USA.
¹⁸ Department of Psychiatry and Behavioral Sciences, MIND Institute, University of California Davis, Davis, CA, USA.
¹⁹ Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA.
²⁰ Department of Pediatrics, Alpert Medical School of Brown University, Providence, RI, USA.
²¹ Department of Pediatrics, Women and Infants Hospital of Rhode Island, Providence, RI, USA.
²² College of Health and Human Services, George Mason University, Fairfax, VA, USA.
²³ Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA.
²⁴ Michigan State University, East Lansing, MI, USA.

PMID: 36417100
PMCID: PMC10150657
DOI: 10.1007/s10802-022-01000-5

Prenatal Antidepressant Exposures and Autism Spectrum Disorder or Traits: A Retrospective, Multi-Cohort Study

Patricia A Brennan et al. Res Child Adolesc Psychopathol. 2023 Apr.

. 2023 Apr;51(4):513-527.

doi: 10.1007/s10802-022-01000-5. Epub 2022 Nov 22.

Authors

Affiliations

¹ Psychology Department, Emory University, 36 Eagle Row, 30322, Atlanta, GA, USA. pbren01@emory.edu.
² Department of Gynecology & Obstetrics, Emory University School of Medicine, Atlanta, GA, USA.
³ Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
⁴ Virginia Commonwealth University School of Nursing, Richmond, VA, USA.
⁵ Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA.
⁶ Health Sciences Center University of New Mexico, Albuquerque, NM, USA.
⁷ Seattle Children's Research Institute, Seattle, WA, USA.
⁸ University of Washington, Seattle, WA, USA.
⁹ Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
¹⁰ Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
¹¹ Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
¹² Departments of Psychiatry, Psychology, Neuroscience, and Obstetrics and Gynecology, University of Rochester, Rochester, NY, USA.
¹³ Avera Research Institute, Dept of Pediatrics, University of South Dakota School of Medicine, Vermillion, SD, USA.
¹⁴ Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Boston, MA, USA.
¹⁵ Beckman Institute for Advanced Science and Technology, University of Illinois Urbana- Champaign, ICF, Urbana, Durham, IL, NC, USA.
¹⁶ Department of Family and Preventive Medicine, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT, USA.
¹⁷ Marshfield Clinic Research Institute, Marshfield Clinic Health System, Marshfield, WI, USA.
¹⁸ Department of Psychiatry and Behavioral Sciences, MIND Institute, University of California Davis, Davis, CA, USA.
¹⁹ Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA.
²⁰ Department of Pediatrics, Alpert Medical School of Brown University, Providence, RI, USA.
²¹ Department of Pediatrics, Women and Infants Hospital of Rhode Island, Providence, RI, USA.
²² College of Health and Human Services, George Mason University, Fairfax, VA, USA.
²³ Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA.
²⁴ Michigan State University, East Lansing, MI, USA.

PMID: 36417100
PMCID: PMC10150657
DOI: 10.1007/s10802-022-01000-5

Abstract

Prenatal antidepressant exposure has been associated with increased risk for neurodevelopmental disorders in childhood, including autism spectrum disorder (ASD). The current study utilized multi-cohort data from the Environmental influences on Child Health Outcomes (ECHO) program (N = 3129) to test for this association, and determine whether the association remained after adjusting for maternal prenatal depression and other potential confounders. Antidepressants and a subset of selective serotonin reuptake inhibitors (SSRIs) were examined in relation to binary (e.g., diagnostic) and continuous measures of ASD and ASD related traits (e.g., social difficulties, behavior problems) in children 1.5 to 12 years of age. Child sex was tested as an effect modifier. While prenatal antidepressant exposure was associated with ASD related traits in univariate analyses, these associations were statistically non-significant in models that adjusted for prenatal maternal depression and other maternal and child characteristics. Sex assigned at birth was not an effect modifier for the prenatal antidepressant and child ASD relationship. Overall, we found no association between prenatal antidepressant exposures and ASD diagnoses or traits. Discontinuation of antidepressants in pregnancy does not appear to be warranted on the basis of increased risk for offspring ASD.

Keywords: Antidepressants; Autism spectrum disorder; Neurodevelopment; Prenatal.

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Conflict of interest statement

Conflicts of Interest

None noted

References

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Prenatal Antidepressant Exposures and Autism Spectrum Disorder or Traits: A Retrospective, Multi-Cohort Study

Affiliations

Prenatal Antidepressant Exposures and Autism Spectrum Disorder or Traits: A Retrospective, Multi-Cohort Study

Authors

Affiliations

Abstract

Conflict of interest statement

References

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Grants and funding

LinkOut - more resources

Full Text Sources

Medical