Table 5.
Estimated adjusted associations between ASD related outcomes and prenatal SSRI use exposure
| Models | Coefficient/OR | LCL | UCL | P-value |
|---|---|---|---|---|
| SRS total raw ~ SSRI, N=1214 | ||||
| Prenatal SSRI use Yes vs. No | 0.9 | −6.8 | 8.6 | 0.82 |
| Age at visit for the outcome, yrs | 0.4 | −0.5 | 1.2 | 0.39 |
| Child’s sex: Female vs. Male | −4.4 | −7.0 | −1.8 | 0.001 |
| Prenatal depression diagnosis: Yes vs. No | 4.2 | −0.8 | 9.2 | 0.10 |
| Maternal age at delivery, yrs | 0.0 | −0.2 | 0.3 | 0.87 |
| Maternal Non-Hispanic white vs. others | −3.0 | −6.1 | 0.1 | 0.06 |
| Maternal above vs. less than high school education | −10.2 | −14.4 | −6.0 | <0.001 |
| Maternal not married vs. married | 8.6 | 4.7 | 12.4 | <0.001 |
| Prenatal tobacco use: Yes vs. No | 2.5 | −2.2 | 7.3 | 0.30 |
| Prenatal alcohol use: Yes vs. No | 0.2 | −3.9 | 4.2 | 0.94 |
| Prenatal marijuana use: Yes vs. No | 2.2 | −5.4 | 9.7 | 0.57 |
| Pre-pregnancy BMI, kg/m2 | 0.4 | 0.2 | 0.6 | <0.001 |
| CBCL DSM-5 Autism t score for preschool children ~ SSRI, N=1072 | ||||
| Prenatal SSRI use Yes vs. No | 0.4 | −2.1 | 2.9 | 0.76 |
| Age at visit for the outcome, yrs | 0.01 | −0.6 | 0.6 | 0.98 |
| Child’s sex: Female vs. Male | −0.8 | −1.6 | −0.1 | 0.04 |
| Prenatal depression diagnosis: Yes vs. No | 1.9 | 0.2 | 3.5 | 0.03 |
| Maternal age at delivery, yrs | −0.02 | −0.1 | 0.1 | 0.70 |
| Maternal Non-Hispanic white vs. others | −0.7 | −1.6 | 0.2 | 0.13 |
| Maternal above vs. less than high school education | −1.2 | −2.3 | −0.1 | 0.04 |
| Maternal not married vs. married | 1.5 | 0.3 | 2.6 | 0.01 |
| Prenatal tobacco use: Yes vs. No | 0.7 | −0.6 | 2.0 | 0.29 |
| Prenatal alcohol use: Yes vs. No | −1.2 | −2.4 | −0.1 | 0.04 |
| Prenatal marijuana use: Yes vs. No | 1.2 | −0.6 | 2.9 | 0.20 |
| Pre-pregnancy BMI, kg/m2 | 0.04 | −0.01 | 0.1 | 0.15 |
| CBCL Autism Sum t score for school age children ~ SSRI, N=477 | ||||
| Prenatal SSRI use Yes vs. No | 1.1 | −6.8 | 9.0 | 0.79 |
| Age at visit for the outcome, yrs | −0.6 | −2.2 | 1.0 | 0.48 |
| Child’s sex: Female vs. Male | −3.0 | −5.8 | −0.2 | 0.04 |
| Prenatal depression diagnosis: Yes vs. No | −2.7 | −8.4 | 3.0 | 0.35 |
| Maternal age at delivery, yrs | −0.1 | −0.3 | 0.2 | 0.50 |
| Maternal Non-Hispanic white vs. others | 0.5 | −3.0 | 4.1 | 0.77 |
| Maternal above vs. less than high school education | −1.0 | −6.6 | 4.5 | 0.71 |
| Maternal not married vs. married | 6.9 | 2.3 | 11.5 | 0.003 |
| Prenatal tobacco use: Yes vs. No | 1.9 | −2.9 | 6.7 | 0.44 |
| Prenatal alcohol use: Yes vs. No | 3.6 | −0.6 | 7.9 | 0.09 |
| Prenatal marijuana use: Yes vs. No | 16.1 | 2.9 | 29.3 | 0.02 |
| Pre-pregnancy BMI, kg/m2 | 0.5 | 0.3 | 0.7 | <0.001 |
| ASD diagnosis ~ SSRI, N=2323 | ||||
| Prenatal SSRI use Yes vs. No | 1.5 | 0.6 | 3.5 | 0.38 |
| Age at visit for the outcome, yrs | 1.2 | 1.1 | 1.4 | 0.004 |
| Child’s sex: Female vs. Male | 0.4 | 0.3 | 0.6 | <0.001 |
| Prenatal depression diagnosis: Yes vs. No | 1.2 | 0.8 | 1.8 | 0.49 |
| Maternal age at delivery, yrs | 1.0 | 1.0 | 1.0 | 0.29 |
| Maternal Non-Hispanic white vs. others | 1.3 | 1.0 | 1.8 | 0.08 |
| Maternal above vs. less than high school education | 0.9 | 0.6 | 1.3 | 0.62 |
| Maternal not married vs. married | 1.2 | 0.9 | 1.8 | 0.24 |
| Prenatal tobacco use: Yes vs. No | 1.5 | 0.9 | 2.3 | 0.09 |
| Prenatal alcohol use: Yes vs. No | 0.6 | 0.3 | 1.2 | 0.18 |
| Prenatal marijuana use: Yes vs. No | 0.9 | 0.5 | 1.7 | 0.72 |
| Pre-pregnancy BMI, kg/m2 | 1.0 | 1.0 | 1.0 | 0.76 |
| MCHAT ~ SSRI, N=761 | ||||
| Prenatal SSRI use Yes vs. No | 1.0 | 0.2 | 5.8 | 0.99 |
| Age at visit for the outcome, yrs | 0.8 | 0.5 | 1.2 | 0.26 |
| Child’s sex: Female vs. Male | 0.5 | 0.3 | 0.8 | 0.01 |
| Prenatal depression diagnosis: Yes vs. No | 0.8 | 0.3 | 1.9 | 0.56 |
| Maternal age at delivery, yrs | 1.0 | 1.0 | 1.1 | 0.12 |
| Maternal Non-Hispanic white vs. others | 0.8 | 0.5 | 1.4 | 0.50 |
| Maternal above vs. less than high school education | 0.4 | 0.2 | 0.6 | <0.001 |
| Maternal not married vs. married | 1.9 | 1.2 | 3.2 | 0.01 |
| Prenatal tobacco use: Yes vs. No | 1.7 | 0.9 | 3.2 | 0.08 |
| Prenatal alcohol use: Yes vs. No | 1.1 | 0.4 | 3.4 | 0.83 |
| Prenatal marijuana use: Yes vs. No | 0.7 | 0.3 | 1.5 | 0.33 |
| Pre-pregnancy BMI, kg/m2 | 1.0 | 1.0 | 1.0 | 0.28 |
ASD, autism spectrum disorder; BMI, body mass index; CBCL, Child Behavior Checklist; LCL, lower confidence limit; M-CHAT-R/F, Modified Checklist for Autism in Toddlers-Revised with Follow-up; OR, odds ratio; SRS-2, Social Responsiveness Scale, Second Edition; SSRI, selective serotonin reuptake inhibitors; UCL, upper confidence limit