Association of Selective Serotonin Reuptake Inhibitor Exposure During Pregnancy With Speech, Scholastic, and Motor Disorders in Offspring
Association of Selective Serotonin Reuptake Inhibitor Exposure During Pregnancy With Speech, Scholastic, and Motor Disorders in Offspring
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DOI：
10.1001/jamapsychiatry.2016.2594
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发表时间：
2016-11-01
期刊：
影响因子：
25.8
通讯作者：
Sourander, Andre
中科院分区：
文献类型：
--
作者：
Brown, Alan S.;Gyllenberg, David;Sourander, Andre
重要性言语/语言、学习和运动障碍在儿童中很常见。目前尚不清楚孕期暴露于选择性5-羟色胺再摄取抑制剂（SSRIs）是否会影响对这些疾病的易感性。这项前瞻性出生队列研究检查了1996年至2010年芬兰全国人口登记数据。本研究以845345名孕妇及其独生子女为研究对象，收集了孕妇孕期服用抗抑郁药和抑郁症相关精神疾病的资料。9537人属于未用药组，即母亲被诊断为患有抑郁症相关的精神疾病，但在怀孕期间没有购买SSRIs的历史; 31207例为未暴露组，即母亲无精神病诊断或购买SSRIs史。主要结果和指标言语/语言、学习或运动障碍的累积发病率（分别为829例、187例和285例）。所有的假设测试前制定的数据collection.Results的56340名婴儿包括在最终的队列，28684（50.9%）是男性和48782（86.6%）是9岁或以下。诊断为言语/语言障碍、学习障碍和运动障碍的儿童的平均（SD）年龄分别为4.43（1.67）、3.55（2.67）和7.73（2.38）。在怀孕期间购买SSRIs至少两次的母亲的后代与未用药组的后代相比，言语/语言障碍的风险显著增加37%。SSRI暴露组言语/语言障碍的累积风险为0.0087，未用药组为0.0061（风险比，1.37; 95%CI，1.11-1.70; P = 0.004）。与未暴露组的后代相比，SSRI暴露组和未用药组的后代发生这些疾病的风险显著增加。对于学习和运动障碍，有SSRI暴露组和unmedicated group.CONCLUSIONS和RELEVANCE暴露于SSRIs在怀孕期间与言语/语言障碍的风险增加的后代之间没有差异。这一发现可能对理解SSRIs和儿童发育之间的联系有影响。
IMPORTANCE Speech/language, scholastic, and motor disorders are common in children. It is unknown whether exposure to selective serotonin reuptake inhibitors (SSRIs) during pregnancy influences susceptibility to these disorders.OBJECTIVE To examine whether SSRI exposure during pregnancy is associated with speech/language, scholastic, and motor disorders in offspring up to early adolescence.DESIGN, SETTING, AND PARTICIPANTS This prospective birth cohort study examined national population-based register data in Finland from 1996 to 2010. The sampling frame includes 845 345 pregnant women and their singleton offspring with data on maternal use of antidepressants and depression-related psychiatric disorders during pregnancy.EXPOSURES There were 3 groups of offspring: 15 596 were in the SSRI-exposed group, ie, had mothers diagnosed as having depression-related psychiatric disorders with a history of purchasing SSRIs during pregnancy; 9537 were in the unmedicated group, ie, had mothers diagnosed as having depression-related psychiatric disorders without a history of purchasing SSRIs during pregnancy; and 31 207 were in the unexposed group, ie, had mothers without a psychiatric diagnosis or a history of purchasing SSRIs.MAIN OUTCOMES AND MEASURES Cumulative incidence of speech/language, scholastic, or motor disorders (829, 187, and 285 instances, respectively) from birth to 14 years. All hypotheses tested were formulated before data collection.RESULTS Of the 56 340 infants included in the final cohort, 28 684 (50.9%) were male and 48 782 (86.6%) were 9 years or younger. The mean (SD) ages of children at diagnosis were 4.43 (1.67), 3.55 (2.67), and 7.73 (2.38) for speech/language, scholastic, and motor disorders, respectively. Offspring of mothers who purchased SSRIs at least twice during pregnancy had a significant 37% increased risk of speech/language disorders compared with offspring in the unmedicated group. The cumulative hazard of speech/language disorders was 0.0087 in the SSRI-exposed group vs 0.0061 in the unmedicated group (hazard ratio, 1.37; 95% CI, 1.11-1.70; P =.004). There was a significantly increased risk of these disorders in offspring in the SSRI-exposed and unmedicated groups compared with offspring in the unexposed group. For scholastic and motor disorders, there were no differences between offspring in the SSRI-exposed group and in the unmedicated group.CONCLUSIONS AND RELEVANCE Exposure to SSRIs during pregnancy was associated with an increased risk of speech/language disorders. This findingmay have implications for understanding associations between SSRIs and child development.