Table 2. Summary of Studies Exploring the Association of Maternal Clinical Antidepressant Use with the Incidence of ASD Diagnosis in Prenatally Exposed Offspring.
Studies from the last ten years clearly show continued controversy with regard to whether or not gestational exposure to SSRIs increases ASD incidence or risk.
| Antidepressant Class | Offspring ASD Association? | Study Type | Statistical Ratios | Sample Size* |
Source |
|---|---|---|---|---|---|
| SSRIs | Yes | Population Based | OR 2.2, 95% CI 1.2-4.3 | 1,805 | Croen et al., 2011 [170] |
| SNRIs, SSRIs | Yes | Population Based | OR 3.34, 95% CI 1.50-7.47 | 47,749 | Rai et al., 2013 [171] |
| SSRIs, SNRIs, TCAs | No | Population Based | HR 1.5, 95% CI 1.2-1.9 | 655,615 | Sørensen et al., 2013 [179] |
| SSRIs | No | Population Based | RR 1.20, 95% CI 0.90-1.61 | 5,061,174 | Hviid et al., 2013 [180] |
| SSRIs | Yes | Population Based | OR 1.91, 95% CI 1.13-3.47 | 4264 | El Marroun et al., 2014 [172] |
| SSRIs | Yes | Retrospective | OR 2.0, 95% CI 1.6-2/6 | 628,408 | Gidaya et al., 2014 [173] |
| SSRIs | Yes | Population Based | OR 3.22, 95% CI: 1.7-8.84 | 966 | Harrington et al., 2014 [174] |
| Antidepressants NOS | No | Retrospective | OR 1.10, 95% CI: 0.70-1.70 | 5399 | Clements et al., 2015 [181] |
| SSRIs | Yes | Meta-analysis | OR 2.13, 95% CI 1.66-2.73 | 79,221 | Man et al., 2015 [175] |
| Antidepressants NOS | No | Replication Study | OR 0.90, 95% CI 0.50-1.54 | 4,650 | Castro et al., 2016 [182] |
| MAOIs, SSRIs, SNRIs, TCAs |
Yes | Population Based | HR 1.87, 95% CI 1.15-3.04 | 145,456 | Boukhris et al., 2016 [176] |
| SSRIs | No | Retrospective | HR 1.4, 9%% CI 1.02-1.92 | 64,754 | Malm et al., 2016 [[183] |
| SSRIs | Yes | Meta-analysis | OR 1.82, 95% CI 1.59-2.10 | 65,782 | Andalib et al., 2017 [177] |
| NDRIs, SSRIs, SNRIs, TCAs |
Yes | Population Based | F = 4.882, p = 0.027 | 2,748 | Ackerman et al., 2017 [147] |
| NDRIs, SSRIs, SNRIs, TCAs |
No | Population based | RR 1.23, 95% CI 0.96-1.57 | 179,077 | Viktorin et al., 2017 [184] |
| NDRIs, SSRIs, SNRIs, TCAs |
No | Retrospective | HR 0.83, 95% CI 0.62-1.13 | 1,580,629 | Sujan et al., 2017 [[185] |
| SNRIs, SSRIs | No | Retrospective | HR 1.61, 95% CI 0.997-2.59 | 35906 | Brown et al., 2017 [186] |
| SSRIs | Yes | Meta-analysis | HR 1.61, 95% CI 1.16-2-25 | 2,133,811 | Kaplan et al., 2017 [178] |
KEY: MAOI: Monoamine Oxidase Inhibitor; NOS: Not Otherwise Specified; SNRI: Serotonin and Norepinephrine Reuptake Inhibitor; NDRI: Norepinephrine and Dopamine Reuptake Inhibitor; SNRI: Serotonin-norepinephrine Reuptake Inhibitors; SSRI: Selective Serotonin Reuptake Inhibitor; TCA: Tricyclic Antidepressants. SSRIs may include: citalopram, fluoxetine, fluvoxamine, paroxetine, and sertraline. F: F Ratio; HR: Hazards Ratio; OR: Odds Ratio; RR: Rates Ratio. See cited references for full study details.
Sample size only includes control populations and ASD relevant samples, not necessarily the total population studied in the citation (e.g., some papers included ADHD populations in addition to ASD).