Maternal SSRI exposure increases the risk of autistic offspring: A meta-analysis and systematic review

Background: Selective serotonin reuptake inhibitors (SSRIs) are the most common antidepressants used to preclude maternal pregnancy depression. There is a growing body of literature assessing the association of prenatal exposure to SSRIs with autism spectrum disorder (ASD). The present systematic review and meta-analysis reviewed the medical literature and pooled the results of the association of prenatal exposure to SSRIs with ASD. Methods: Published investigations in English by June 2016 with keywords of selective serotonin reuptake inhibitors, SSRI, autism spectrum disorder, ASD, pregnancy, childhood, children, neurodevelopment were identified using databases PubMed and PMC, MEDLINE, EMBASE, SCOPUS, and Google Scholar. Cochran's Q statistic-value (Q), degree of freedom (df), and I-2 indices (variation in odds ratio [OR] attributable to heterogeneity) were calculated to analyze the risk of heterogeneity of the within-and between-study variability. Pooled odds ratio (OR) and 95% confidence interval (CI) were reported by a Mantel-Haenszel test. Results: There was a non-significant heterogeneity for the included studies ([Q = 3.61, df = 6, P = 0.730], I-2 = 0%). The pooled results showed a significant association between prenatal SSRI exposure and ASD (OR = 1.82, 95% CI = 1.59-2.10, Z = 8.49, P = 0.00). Conclusion: The evidence from the present study suggests that prenatal exposure to SSRIs is associated with a higher risk of ASD. (C) 2017 Elsevier Masson SAS. All rights reserved.