TY - JOUR
T1 - Association of Selective Serotonin Reuptake Inhibitor Exposure During Pregnancy With Speech, Scholastic, and Motor Disorders in Offspring
AU - Brown, Alan S
AU - Gyllenberg, David
AU - Malm, Heli
AU - McKeague, Ian W
AU - Hinkka-Yli-Salomäki, Susanna
AU - Artama, Miia
AU - Gissler, Mika
AU - Cheslack-Postava, Keely
AU - Weissman, Myrna M
AU - Gingrich, Jay A
AU - Sourander, Andre
PY - 2016/11/1
Y1 - 2016/11/1
N2 - IMPORTANCE: Speech/language, scholastic, and motor disorders are common in children. It is unknown whether exposure to selective serotonin reuptake inhibitors (SSRIs) during pregnancy influences susceptibility to these disorders.OBJECTIVE: To examine whether SSRI exposure during pregnancy is associated with speech/language, scholastic, and motor disorders in offspring up to early adolescence.DESIGN, SETTING, AND PARTICIPANTS: This prospective birth cohort study examined national population-based register data in Finland from 1996 to 2010. The sampling frame includes 845 345 pregnant women and their singleton offspring with data on maternal use of antidepressants and depression-related psychiatric disorders during pregnancy.EXPOSURES: There were 3 groups of offspring: 15 596 were in the SSRI-exposed group, ie, had mothers diagnosed as having depression-related psychiatric disorders with a history of purchasing SSRIs during pregnancy; 9537 were in the unmedicated group, ie, had mothers diagnosed as having depression-related psychiatric disorders without a history of purchasing SSRIs during pregnancy; and 31 207 were in the unexposed group, ie, had mothers without a psychiatric diagnosis or a history of purchasing SSRIs.MAIN OUTCOMES AND MEASURES: Cumulative incidence of speech/language, scholastic, or motor disorders (829, 187, and 285 instances, respectively) from birth to 14 years. All hypotheses tested were formulated before data collection.RESULTS: Of the 56 340 infants included in the final cohort, 28 684 (50.9%) were male and 48 782 (86.6%) were 9 years or younger. The mean (SD) ages of children at diagnosis were 4.43 (1.67), 3.55 (2.67), and 7.73 (2.38) for speech/language, scholastic, and motor disorders, respectively. Offspring of mothers who purchased SSRIs at least twice during pregnancy had a significant 37% increased risk of speech/language disorders compared with offspring in the unmedicated group. The cumulative hazard of speech/language disorders was 0.0087 in the SSRI-exposed group vs 0.0061 in the unmedicated group (hazard ratio, 1.37; 95% CI, 1.11-1.70; P = .004). There was a significantly increased risk of these disorders in offspring in the SSRI-exposed and unmedicated groups compared with offspring in the unexposed group. For scholastic and motor disorders, there were no differences between offspring in the SSRI-exposed group and in the unmedicated group.CONCLUSIONS AND RELEVANCE: Exposure to SSRIs during pregnancy was associated with an increased risk of speech/language disorders. This finding may have implications for understanding associations between SSRIs and child development.
AB - IMPORTANCE: Speech/language, scholastic, and motor disorders are common in children. It is unknown whether exposure to selective serotonin reuptake inhibitors (SSRIs) during pregnancy influences susceptibility to these disorders.OBJECTIVE: To examine whether SSRI exposure during pregnancy is associated with speech/language, scholastic, and motor disorders in offspring up to early adolescence.DESIGN, SETTING, AND PARTICIPANTS: This prospective birth cohort study examined national population-based register data in Finland from 1996 to 2010. The sampling frame includes 845 345 pregnant women and their singleton offspring with data on maternal use of antidepressants and depression-related psychiatric disorders during pregnancy.EXPOSURES: There were 3 groups of offspring: 15 596 were in the SSRI-exposed group, ie, had mothers diagnosed as having depression-related psychiatric disorders with a history of purchasing SSRIs during pregnancy; 9537 were in the unmedicated group, ie, had mothers diagnosed as having depression-related psychiatric disorders without a history of purchasing SSRIs during pregnancy; and 31 207 were in the unexposed group, ie, had mothers without a psychiatric diagnosis or a history of purchasing SSRIs.MAIN OUTCOMES AND MEASURES: Cumulative incidence of speech/language, scholastic, or motor disorders (829, 187, and 285 instances, respectively) from birth to 14 years. All hypotheses tested were formulated before data collection.RESULTS: Of the 56 340 infants included in the final cohort, 28 684 (50.9%) were male and 48 782 (86.6%) were 9 years or younger. The mean (SD) ages of children at diagnosis were 4.43 (1.67), 3.55 (2.67), and 7.73 (2.38) for speech/language, scholastic, and motor disorders, respectively. Offspring of mothers who purchased SSRIs at least twice during pregnancy had a significant 37% increased risk of speech/language disorders compared with offspring in the unmedicated group. The cumulative hazard of speech/language disorders was 0.0087 in the SSRI-exposed group vs 0.0061 in the unmedicated group (hazard ratio, 1.37; 95% CI, 1.11-1.70; P = .004). There was a significantly increased risk of these disorders in offspring in the SSRI-exposed and unmedicated groups compared with offspring in the unexposed group. For scholastic and motor disorders, there were no differences between offspring in the SSRI-exposed group and in the unmedicated group.CONCLUSIONS AND RELEVANCE: Exposure to SSRIs during pregnancy was associated with an increased risk of speech/language disorders. This finding may have implications for understanding associations between SSRIs and child development.
KW - Antidepressive Agents/adverse effects
KW - Case-Control Studies
KW - Child
KW - Child, Preschool
KW - Cohort Studies
KW - Depressive Disorder/drug therapy
KW - Female
KW - Finland
KW - Humans
KW - Language Development Disorders/chemically induced
KW - Learning Disabilities/chemically induced
KW - Male
KW - Motor Disorders/chemically induced
KW - Pregnancy
KW - Pregnancy Complications/drug therapy
KW - Prenatal Exposure Delayed Effects/chemically induced
KW - Proportional Hazards Models
KW - Prospective Studies
KW - Risk
KW - Selective Serotonin Reuptake Inhibitors/adverse effects
KW - Speech Disorders/chemically induced
U2 - 10.1001/jamapsychiatry.2016.2594
DO - 10.1001/jamapsychiatry.2016.2594
M3 - Article
C2 - 27732704
SN - 2168-622X
VL - 73
SP - 1163
EP - 1170
JO - JAMA Psychiatry
JF - JAMA Psychiatry
IS - 11
ER -