Maternal Psychiatric Conditions, Treatment with SSRIs, and Neurodevelopmental Disorders

ABSTRACT Background The present study aims to clarify relationships of maternal psychiatric conditions and selective serotonin reuptake inhibitors (SSRI) use during preconception and pregnancy with risk of neurodevelopmental disorders in offspring. Methods We used data from the Study to Explore Early Development, a multisite case-control study conducted in the United States among children born between 2003-2011. Final study group classifications of ASD (n=1367), DD (n= 1750), and general population controls (POP)(n=1671) were determined by an in-person standardized developmental assessment. Maternal psychiatric conditions and SSRI use during pregnancy were ascertained from both self-report and medical records. We used logistic regression to evaluate associations of ASD and DD (vs. POP) with maternal psychiatric condition and SSRI treatment in pregnancy. To reduce confounding by indication, we also examined SSRI associations in analyses restricted to mothers with psychiatric conditions during pregnancy. Results Psychiatric conditions and SSRI use during pregnancy were significantly more common among mothers of children with either ASD or DD than POP controls. Odds of ASD were similarly elevated among mothers with psychiatric conditions who did not use SSRIs during pregnancy (adjusted odds ratio (aOR)=1.81, 95% confidence interval (CI) 1.44-2.27) as in mothers who did use SSRIs (aOR=2.05, 95% CI 1.50-2.80). Among mothers with psychiatric conditions, SSRI use was not significantly associated with ASD in offspring (aOR=1.14, 95% CI 0.8-1.62). Primary findings for DD exhibited similar relationships to those observed with ASD. Conclusions Maternal psychiatric conditions, but not use of SSRIs during pregnancy, were associated with increased risk of neurodevelopmental disorders in offspring.