Prenatal antidepressant exposure is associated with risk for attention-deficit hyperactivity disorder but not autism spectrum disorder in a large health system.
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| Title: | Prenatal antidepressant exposure is associated with risk for attention-deficit hyperactivity disorder but not autism spectrum disorder in a large health system. |
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| Authors: | Clements, C C, Castro, V M, Blumenthal, S R, Rosenfield, H R, Murphy, S N, Fava, M, Erb, J L, Churchill, S E, Kaimal, A J, Doyle, A E, Robinson, E B, Smoller, J W, Kohane, I S, Perlis, R H |
| Source: | Molecular Psychiatry. Jun2015, Vol. 20 Issue 6, p727-734. 8p. |
| Subjects: | Antidepressants, Risk factors of attention-deficit hyperactivity disorder, Autism spectrum disorders in children, Mental depression, Pregnancy complications, Logistic regression analysis |
| Abstract: | Previous studies suggested that risk for Autism Spectrum Disorder (ASD) may be increased in children exposed to antidepressants during the prenatal period. The disease specificity of this risk has not been addressed and the possibility of confounding has not been excluded. Children with ASD or attention-deficit hyperactivity disorder (ADHD) delivered in a large New England health-care system were identified from electronic health records (EHR), and each diagnostic group was matched 1:3 with children without ASD or ADHD. All children were linked with maternal health data using birth certificates and EHRs to determine prenatal medication exposures. Multiple logistic regression was used to examine association between prenatal antidepressant exposures and ASD or ADHD risk. A total of 1377 children diagnosed with ASD and 2243 with ADHD were matched with healthy controls. In models adjusted for sociodemographic features, antidepressant exposure prior to and during pregnancy was associated with ASD risk, but risk associated with exposure during pregnancy was no longer significant after controlling for maternal major depression (odds ratio (OR) 1.10 (0.70-1.70)). Conversely, antidepressant exposure during but not prior to pregnancy was associated with ADHD risk, even after adjustment for maternal depression (OR 1.81 (1.22-2.70)). These results suggest that the risk of autism observed with prenatal antidepressant exposure is likely confounded by severity of maternal illness, but further indicate that such exposure may still be associated with ADHD risk. This risk, modest in absolute terms, may still be a result of residual confounding and must be balanced against the substantial consequences of untreated maternal depression. [ABSTRACT FROM AUTHOR] |
| Copyright of Molecular Psychiatry is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
| Database: | Psychology and Behavioral Sciences Collection |
| FullText | Links: – Type: pdflink Text: Availability: 0 |
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| Header | DbId: pbh DbLabel: Psychology and Behavioral Sciences Collection An: 102779110 AccessLevel: 6 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
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| Items | – Name: Title Label: Title Group: Ti Data: Prenatal antidepressant exposure is associated with risk for attention-deficit hyperactivity disorder but not autism spectrum disorder in a large health system. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Clements%2C+C+C%22">Clements, C C</searchLink><br /><searchLink fieldCode="AR" term="%22Castro%2C+V+M%22">Castro, V M</searchLink><br /><searchLink fieldCode="AR" term="%22Blumenthal%2C+S+R%22">Blumenthal, S R</searchLink><br /><searchLink fieldCode="AR" term="%22Rosenfield%2C+H+R%22">Rosenfield, H R</searchLink><br /><searchLink fieldCode="AR" term="%22Murphy%2C+S+N%22">Murphy, S N</searchLink><br /><searchLink fieldCode="AR" term="%22Fava%2C+M%22">Fava, M</searchLink><br /><searchLink fieldCode="AR" term="%22Erb%2C+J+L%22">Erb, J L</searchLink><br /><searchLink fieldCode="AR" term="%22Churchill%2C+S+E%22">Churchill, S E</searchLink><br /><searchLink fieldCode="AR" term="%22Kaimal%2C+A+J%22">Kaimal, A J</searchLink><br /><searchLink fieldCode="AR" term="%22Doyle%2C+A+E%22">Doyle, A E</searchLink><br /><searchLink fieldCode="AR" term="%22Robinson%2C+E+B%22">Robinson, E B</searchLink><br /><searchLink fieldCode="AR" term="%22Smoller%2C+J+W%22">Smoller, J W</searchLink><br /><searchLink fieldCode="AR" term="%22Kohane%2C+I+S%22">Kohane, I S</searchLink><br /><searchLink fieldCode="AR" term="%22Perlis%2C+R+H%22">Perlis, R H</searchLink> – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22Molecular+Psychiatry%22">Molecular Psychiatry</searchLink>. Jun2015, Vol. 20 Issue 6, p727-734. 8p. – Name: Subject Label: Subjects Group: Su Data: <searchLink fieldCode="DE" term="%22Antidepressants%22">Antidepressants</searchLink><br /><searchLink fieldCode="DE" term="%22Risk+factors+of+attention-deficit+hyperactivity+disorder%22">Risk factors of attention-deficit hyperactivity disorder</searchLink><br /><searchLink fieldCode="DE" term="%22Autism+spectrum+disorders+in+children%22">Autism spectrum disorders in children</searchLink><br /><searchLink fieldCode="DE" term="%22Mental+depression%22">Mental depression</searchLink><br /><searchLink fieldCode="DE" term="%22Pregnancy+complications%22">Pregnancy complications</searchLink><br /><searchLink fieldCode="DE" term="%22Logistic+regression+analysis%22">Logistic regression analysis</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: Previous studies suggested that risk for Autism Spectrum Disorder (ASD) may be increased in children exposed to antidepressants during the prenatal period. The disease specificity of this risk has not been addressed and the possibility of confounding has not been excluded. Children with ASD or attention-deficit hyperactivity disorder (ADHD) delivered in a large New England health-care system were identified from electronic health records (EHR), and each diagnostic group was matched 1:3 with children without ASD or ADHD. All children were linked with maternal health data using birth certificates and EHRs to determine prenatal medication exposures. Multiple logistic regression was used to examine association between prenatal antidepressant exposures and ASD or ADHD risk. A total of 1377 children diagnosed with ASD and 2243 with ADHD were matched with healthy controls. In models adjusted for sociodemographic features, antidepressant exposure prior to and during pregnancy was associated with ASD risk, but risk associated with exposure during pregnancy was no longer significant after controlling for maternal major depression (odds ratio (OR) 1.10 (0.70-1.70)). Conversely, antidepressant exposure during but not prior to pregnancy was associated with ADHD risk, even after adjustment for maternal depression (OR 1.81 (1.22-2.70)). These results suggest that the risk of autism observed with prenatal antidepressant exposure is likely confounded by severity of maternal illness, but further indicate that such exposure may still be associated with ADHD risk. This risk, modest in absolute terms, may still be a result of residual confounding and must be balanced against the substantial consequences of untreated maternal depression. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of Molecular Psychiatry is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1038/mp.2014.90 Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 8 StartPage: 727 Subjects: – SubjectFull: Antidepressants Type: general – SubjectFull: Risk factors of attention-deficit hyperactivity disorder Type: general – SubjectFull: Autism spectrum disorders in children Type: general – SubjectFull: Mental depression Type: general – SubjectFull: Pregnancy complications Type: general – SubjectFull: Logistic regression analysis Type: general Titles: – TitleFull: Prenatal antidepressant exposure is associated with risk for attention-deficit hyperactivity disorder but not autism spectrum disorder in a large health system. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Clements, C C – PersonEntity: Name: NameFull: Castro, V M – PersonEntity: Name: NameFull: Blumenthal, S R – PersonEntity: Name: NameFull: Rosenfield, H R – PersonEntity: Name: NameFull: Murphy, S N – PersonEntity: Name: NameFull: Fava, M – PersonEntity: Name: NameFull: Erb, J L – PersonEntity: Name: NameFull: Churchill, S E – PersonEntity: Name: NameFull: Kaimal, A J – PersonEntity: Name: NameFull: Doyle, A E – PersonEntity: Name: NameFull: Robinson, E B – PersonEntity: Name: NameFull: Smoller, J W – PersonEntity: Name: NameFull: Kohane, I S – PersonEntity: Name: NameFull: Perlis, R H IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 06 Text: Jun2015 Type: published Y: 2015 Identifiers: – Type: issn-print Value: 13594184 Numbering: – Type: volume Value: 20 – Type: issue Value: 6 Titles: – TitleFull: Molecular Psychiatry Type: main |
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