TY - JOUR
T1 - Selective serotonin reuptake inhibitors (Ssris) and serotonin nore-pinephrine reuptake inhibitors (snris) during pregnancy and the risk for autism spectrum disorder (asd) and attention deficit hyperactivity disorder (adhd) in the offspring
T2 - A true effect or a bias? a systematic review & meta-analysis
AU - Leshem, Regina
AU - Bar-Oz, Benjamin
AU - Diav-Citrin, Orna
AU - Gbaly, Siham
AU - Soliman, Jessica
AU - Renoux, Christel
AU - Matok, Ilan
N1 - Publisher Copyright:
© 2021 Bentham Science Publishers.
PY - 2021
Y1 - 2021
N2 - Background and Objective: An inconsistent association between exposure to SSRIs and SNRIs and the risk for ASD and ADHD in the Offspring was observed in observational studies. Some suggest that the reported association might be due to unmeasured confounding. We aimed to study this association and to look for sources of bias by performing a systematic review and meta-a-nalysis. Methods: Medline, Embase, and the Cochrane Library were searched up to June 2019 for studies reporting on ASD and ADHD in the Offspring following exposure during pregnancy. We followed the PRISMA 2009 guidelines for data selection and extraction. Outcomes were pooled using ran-dom-effects models and odds ratios (OR), and 95% confidence intervals (CI) were calculated for each outcome using the adjusted point estimate of each study. Results: Eighteen studies were included in the meta-analysis. We found an association between SS-RIs/SNRIs prenatal use and the risk for ASD and ADHD (OR=1.42, 95% CI: 1.23–1.65, I2=58%; OR=1.26, 95% CI: 1.07-1.49, I2=48%, respectively). Similar findings were obtained in women who were exposed to SSRIs/SNRIs before pregnancy, representing statistically significant association with ASD (OR=1.39, 95% CI: 1.24-1.56, I2=33%) and ADHD (OR=1.63, 95% CI: 1.50-1.78, I2=0%) in the Offspring, although they were not exposed to those medications in utero. Conclusions: Although we found an association between exposure to SSRIs/SNRIs during pregnancy and the risk for ASD and ADHD, an association with those disorders was also present for exposure pre-pregnancy, suggesting that the association might be due to unmeasured confounding. We are aiming to further assess the role of potential unmeasured confounding in the estimation of the association and perform a network meta-analysis.
AB - Background and Objective: An inconsistent association between exposure to SSRIs and SNRIs and the risk for ASD and ADHD in the Offspring was observed in observational studies. Some suggest that the reported association might be due to unmeasured confounding. We aimed to study this association and to look for sources of bias by performing a systematic review and meta-a-nalysis. Methods: Medline, Embase, and the Cochrane Library were searched up to June 2019 for studies reporting on ASD and ADHD in the Offspring following exposure during pregnancy. We followed the PRISMA 2009 guidelines for data selection and extraction. Outcomes were pooled using ran-dom-effects models and odds ratios (OR), and 95% confidence intervals (CI) were calculated for each outcome using the adjusted point estimate of each study. Results: Eighteen studies were included in the meta-analysis. We found an association between SS-RIs/SNRIs prenatal use and the risk for ASD and ADHD (OR=1.42, 95% CI: 1.23–1.65, I2=58%; OR=1.26, 95% CI: 1.07-1.49, I2=48%, respectively). Similar findings were obtained in women who were exposed to SSRIs/SNRIs before pregnancy, representing statistically significant association with ASD (OR=1.39, 95% CI: 1.24-1.56, I2=33%) and ADHD (OR=1.63, 95% CI: 1.50-1.78, I2=0%) in the Offspring, although they were not exposed to those medications in utero. Conclusions: Although we found an association between exposure to SSRIs/SNRIs during pregnancy and the risk for ASD and ADHD, an association with those disorders was also present for exposure pre-pregnancy, suggesting that the association might be due to unmeasured confounding. We are aiming to further assess the role of potential unmeasured confounding in the estimation of the association and perform a network meta-analysis.
KW - ADHD
KW - ASD
KW - Antidepressants
KW - Pregnancy
KW - Prenatal exposure
KW - SNRI’s
KW - SSRI’s
UR - http://www.scopus.com/inward/record.url?scp=85107828101&partnerID=8YFLogxK
U2 - 10.2174/1570159X19666210303121059
DO - 10.2174/1570159X19666210303121059
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C2 - 33655866
AN - SCOPUS:85107828101
SN - 1570-159X
VL - 19
SP - 896
EP - 906
JO - Current Neuropharmacology
JF - Current Neuropharmacology
IS - 6
ER -