Maternal Psychiatric Conditions, Treatment With Selective Serotonin Reuptake Inhibitors, and Neurodevelopmental Disorders

Jennifer L. Ames; Christine Ladd-Acosta; M. Daniele Fallin; Yinge Qian; Laura A. Schieve; Carolyn DiGuiseppi; Li Ching Lee; Eric P. Kasten; Guoli Zhou; Jennifer Pinto-Martin; Ellen M. Howerton; Christopher L. Eaton; Lisa A. Croen

doi:10.1016/j.biopsych.2021.04.002

Maternal Psychiatric Conditions, Treatment With Selective Serotonin Reuptake Inhibitors, and Neurodevelopmental Disorders

Jennifer L. Ames, Christine Ladd-Acosta, M. Daniele Fallin, Yinge Qian, Laura A. Schieve, Carolyn DiGuiseppi, Li Ching Lee, Eric P. Kasten, Guoli Zhou, Jennifer Pinto-Martin, Ellen M. Howerton, Christopher L. Eaton, Lisa A. Croen

Bloomberg School of Public Health

Research output: Contribution to journal › Article › peer-review

Abstract

Background: This study aims to clarify relationships of maternal psychiatric conditions and selective serotonin reuptake inhibitor (SSRI) use during preconception and pregnancy with risk of neurodevelopmental disorders in offspring. Methods: We used data from the Study to Explore Early Development, a multisite case-control study conducted in the United States among children born between 2003 and 2011. Final study group classifications of autism spectrum disorder (ASD) (n = 1367), developmental delays or disorders (DDs) (n = 1750), and general population controls (n = 1671) were determined by an in-person standardized developmental assessment. Maternal psychiatric conditions and SSRI use during pregnancy were ascertained from both self-report and medical records. We used logistic regression to evaluate associations of ASD and DDs (vs. population controls) with maternal psychiatric conditions and SSRI treatment in pregnancy. To reduce confounding by indication, we also examined SSRI associations in analyses restricted to mothers with psychiatric conditions during pregnancy. Results: Psychiatric conditions and SSRI use during pregnancy were significantly more common among mothers of children with either ASD or DDs than among population controls. Odds of ASD were similarly elevated among mothers with psychiatric conditions who did not use SSRIs during pregnancy (adjusted odds ratio 1.81, 95% confidence interval 1.44–2.27) as in mothers who did use SSRIs (adjusted odds ratio 2.05, 95% confidence interval 1.50–2.80). Among mothers with psychiatric conditions, SSRI use was not significantly associated with ASD in offspring (adjusted odds ratio 1.14, 95% confidence interval 0.80–1.62). Primary findings for DDs exhibited similar relationships to those observed with ASD. Conclusions: Maternal psychiatric conditions but not use of SSRIs during pregnancy were associated with increased risk of neurodevelopmental disorders in offspring.

Original language	English (US)
Pages (from-to)	253-262
Number of pages	10
Journal	Biological psychiatry
Volume	90
Issue number	4
DOIs	https://doi.org/10.1016/j.biopsych.2021.04.002
State	Published - Aug 15 2021

Keywords

Antidepressants
Autism
Neurodevelopmental Disorders
Perinatal Exposure
Psychiatric Conditions
SSRIs

ASJC Scopus subject areas

Biological Psychiatry

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10.1016/j.biopsych.2021.04.002

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Ames, J. L., Ladd-Acosta, C., Fallin, M. D., Qian, Y., Schieve, L. A., DiGuiseppi, C., Lee, L. C., Kasten, E. P., Zhou, G., Pinto-Martin, J., Howerton, E. M., Eaton, C. L., & Croen, L. A. (2021). Maternal Psychiatric Conditions, Treatment With Selective Serotonin Reuptake Inhibitors, and Neurodevelopmental Disorders. Biological psychiatry, 90(4), 253-262. https://doi.org/10.1016/j.biopsych.2021.04.002

Ames, JL, Ladd-Acosta, C , Fallin, MD, Qian, Y, Schieve, LA, DiGuiseppi, C, Lee, LC, Kasten, EP, Zhou, G, Pinto-Martin, J, Howerton, EM, Eaton, CL & Croen, LA 2021, 'Maternal Psychiatric Conditions, Treatment With Selective Serotonin Reuptake Inhibitors, and Neurodevelopmental Disorders', Biological psychiatry, vol. 90, no. 4, pp. 253-262. https://doi.org/10.1016/j.biopsych.2021.04.002

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abstract = "Background: This study aims to clarify relationships of maternal psychiatric conditions and selective serotonin reuptake inhibitor (SSRI) use during preconception and pregnancy with risk of neurodevelopmental disorders in offspring. Methods: We used data from the Study to Explore Early Development, a multisite case-control study conducted in the United States among children born between 2003 and 2011. Final study group classifications of autism spectrum disorder (ASD) (n = 1367), developmental delays or disorders (DDs) (n = 1750), and general population controls (n = 1671) were determined by an in-person standardized developmental assessment. Maternal psychiatric conditions and SSRI use during pregnancy were ascertained from both self-report and medical records. We used logistic regression to evaluate associations of ASD and DDs (vs. population controls) with maternal psychiatric conditions and SSRI treatment in pregnancy. To reduce confounding by indication, we also examined SSRI associations in analyses restricted to mothers with psychiatric conditions during pregnancy. Results: Psychiatric conditions and SSRI use during pregnancy were significantly more common among mothers of children with either ASD or DDs than among population controls. Odds of ASD were similarly elevated among mothers with psychiatric conditions who did not use SSRIs during pregnancy (adjusted odds ratio 1.81, 95% confidence interval 1.44–2.27) as in mothers who did use SSRIs (adjusted odds ratio 2.05, 95% confidence interval 1.50–2.80). Among mothers with psychiatric conditions, SSRI use was not significantly associated with ASD in offspring (adjusted odds ratio 1.14, 95% confidence interval 0.80–1.62). Primary findings for DDs exhibited similar relationships to those observed with ASD. Conclusions: Maternal psychiatric conditions but not use of SSRIs during pregnancy were associated with increased risk of neurodevelopmental disorders in offspring.",

keywords = "Antidepressants, Autism, Neurodevelopmental Disorders, Perinatal Exposure, Psychiatric Conditions, SSRIs",

author = "Ames, {Jennifer L.} and Christine Ladd-Acosta and Fallin, {M. Daniele} and Yinge Qian and Schieve, {Laura A.} and Carolyn DiGuiseppi and Lee, {Li Ching} and Kasten, {Eric P.} and Guoli Zhou and Jennifer Pinto-Martin and Howerton, {Ellen M.} and Eaton, {Christopher L.} and Croen, {Lisa A.}",

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doi = "10.1016/j.biopsych.2021.04.002",

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T1 - Maternal Psychiatric Conditions, Treatment With Selective Serotonin Reuptake Inhibitors, and Neurodevelopmental Disorders

AU - Ames, Jennifer L.

AU - Ladd-Acosta, Christine

AU - Fallin, M. Daniele

AU - Qian, Yinge

AU - Schieve, Laura A.

AU - DiGuiseppi, Carolyn

AU - Lee, Li Ching

AU - Kasten, Eric P.

AU - Zhou, Guoli

AU - Pinto-Martin, Jennifer

AU - Howerton, Ellen M.

AU - Eaton, Christopher L.

AU - Croen, Lisa A.

PY - 2021/8/15

Y1 - 2021/8/15

N2 - Background: This study aims to clarify relationships of maternal psychiatric conditions and selective serotonin reuptake inhibitor (SSRI) use during preconception and pregnancy with risk of neurodevelopmental disorders in offspring. Methods: We used data from the Study to Explore Early Development, a multisite case-control study conducted in the United States among children born between 2003 and 2011. Final study group classifications of autism spectrum disorder (ASD) (n = 1367), developmental delays or disorders (DDs) (n = 1750), and general population controls (n = 1671) were determined by an in-person standardized developmental assessment. Maternal psychiatric conditions and SSRI use during pregnancy were ascertained from both self-report and medical records. We used logistic regression to evaluate associations of ASD and DDs (vs. population controls) with maternal psychiatric conditions and SSRI treatment in pregnancy. To reduce confounding by indication, we also examined SSRI associations in analyses restricted to mothers with psychiatric conditions during pregnancy. Results: Psychiatric conditions and SSRI use during pregnancy were significantly more common among mothers of children with either ASD or DDs than among population controls. Odds of ASD were similarly elevated among mothers with psychiatric conditions who did not use SSRIs during pregnancy (adjusted odds ratio 1.81, 95% confidence interval 1.44–2.27) as in mothers who did use SSRIs (adjusted odds ratio 2.05, 95% confidence interval 1.50–2.80). Among mothers with psychiatric conditions, SSRI use was not significantly associated with ASD in offspring (adjusted odds ratio 1.14, 95% confidence interval 0.80–1.62). Primary findings for DDs exhibited similar relationships to those observed with ASD. Conclusions: Maternal psychiatric conditions but not use of SSRIs during pregnancy were associated with increased risk of neurodevelopmental disorders in offspring.

AB - Background: This study aims to clarify relationships of maternal psychiatric conditions and selective serotonin reuptake inhibitor (SSRI) use during preconception and pregnancy with risk of neurodevelopmental disorders in offspring. Methods: We used data from the Study to Explore Early Development, a multisite case-control study conducted in the United States among children born between 2003 and 2011. Final study group classifications of autism spectrum disorder (ASD) (n = 1367), developmental delays or disorders (DDs) (n = 1750), and general population controls (n = 1671) were determined by an in-person standardized developmental assessment. Maternal psychiatric conditions and SSRI use during pregnancy were ascertained from both self-report and medical records. We used logistic regression to evaluate associations of ASD and DDs (vs. population controls) with maternal psychiatric conditions and SSRI treatment in pregnancy. To reduce confounding by indication, we also examined SSRI associations in analyses restricted to mothers with psychiatric conditions during pregnancy. Results: Psychiatric conditions and SSRI use during pregnancy were significantly more common among mothers of children with either ASD or DDs than among population controls. Odds of ASD were similarly elevated among mothers with psychiatric conditions who did not use SSRIs during pregnancy (adjusted odds ratio 1.81, 95% confidence interval 1.44–2.27) as in mothers who did use SSRIs (adjusted odds ratio 2.05, 95% confidence interval 1.50–2.80). Among mothers with psychiatric conditions, SSRI use was not significantly associated with ASD in offspring (adjusted odds ratio 1.14, 95% confidence interval 0.80–1.62). Primary findings for DDs exhibited similar relationships to those observed with ASD. Conclusions: Maternal psychiatric conditions but not use of SSRIs during pregnancy were associated with increased risk of neurodevelopmental disorders in offspring.

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KW - Autism

KW - Neurodevelopmental Disorders

KW - Perinatal Exposure

KW - Psychiatric Conditions

KW - SSRIs

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Maternal Psychiatric Conditions, Treatment With Selective Serotonin Reuptake Inhibitors, and Neurodevelopmental Disorders

Abstract

Keywords

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