Article

In utero exposure to selective serotonin reuptake inhibitors and development of mental disorders: a systematic review and meta‐analysis

Acta Psychiatrica Scandinavica, Wiley, ISSN 0001-690X

Volume 139, 6, 2019

DOI:10.1111/acps.13030, Dimensions: pub.1113171611, PMID: 30937904,

Authors

Halvorsen, A. (1) (2)
Hesel, B. (1) (2)

Affiliations

Organisations

  1. (1) Aarhus University, grid.7048.b, AU
  2. (2) Aarhus University Hospital, grid.154185.c, Central Denmark Region

Countries

Denmark

Continents

Europe

Description

OBJECTIVE: Several studies have investigated whether in utero exposure to selective serotonin reuptake inhibitors (SSRIs) is associated with increased risk of developing mental or behavioural disorders. The aim of this study was to perform a systematic review and meta-analysis based on this literature. METHODS: A systematic search of eligible literature in PubMed, EMBASE, and PsycINFO and subsequent meta-analysis was conducted in adherence with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guideline. RESULTS: A total of 20 studies were included in the review, and results from 18 of these were meta-analyzed. We found a statistically significant positive association between in utero exposure to SSRIs and mental or behavioural disorders such as autism spectrum disorder (hazard ratio (HR) = 1.27; 95% confidence interval (CI) = 1.10-1.47), attention-deficit/hyperactivity disorder (HR = 1.33; 95% CI = 1.06-1.66) and mental retardation (HR = 1.41; 95% CI = 1.03-1.91). Confounding by indication was identified in five of seven studies investigating this aspect. CONCLUSION: Exposure to SSRIs in utero is associated with increased risk of developing mental or behavioural disorders. However, these associations do not necessarily reflect a causal relationship since the results included in this meta-analysis are likely affected by residual confounding by indication, which is likely to account for some (or all) of the positive association.

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Times Cited: 9