At the same time, attention to paternal factors has increased in relation to fetal and offspring health, but research on potential adverse effects on offspring due to paternal antidepressant treatment is limited. Three mutually exclusive exposure groups were created in the study: children born to fathers receiving antidepressant treatment during the conception period (A; from four weeks before estimated conception date to four weeks after); children born to fathers receiving no antidepressant treatment during the conception period (A) but who started treatment during the pregnancy period only (B; from four weeks after the estimated conception date to end of pregnancy); and children born to fathers not receiving antidepressant treatment during the conception period or pregnancy period, Risk of adverse outcomes in offspring born to fathers receiving antidepressant treatment during conception or pregnancy periods, versus offspring born to unexposed fathers. The .gov means its official. About Lexapro. This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. Antidepressants during pregnancy and autism in offspring: population based cohort study. In the first comparison, 3983 children born to fathers receiving antidepressant drug treatment during the conception period were compared with 164492 unexposed children. We publish a number of journals covering major specialties and a growing number of online products for doctors and patients. The Swedish Prescribed Drug Register began on 1 July 2005; if a father had a dispensation of an antidepressant drug just before this date, it would either be undetected if only one dispensation was made, or be defined as treatment that began during pregnancy if there was a follow-up dispensation. HHS Vulnerability Disclosure, Help Of the 3342 children exposed to antidepressants during pregnancy, 136 (4.1%) had a diagnosis of autism. No association was seen between antidepressant use during conception and autism (adjusted hazard ratio 1.13 (0.84 to 1.53)) or intellectual disability (0.82 (0.51 to 1.31)) using Cox regression. Each child was followed from birth until a diagnosis of the outcome, death, or end of follow-up at 31 December 2014, whichever event occurred first. This site needs JavaScript to work properly. The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. and widely read medical journal. 8600 Rockville Pike BMC Med. A Review of the Evidence. Figure presents hazard ratios for autism and intellectual disability, odds ratios for preterm birth and malformation, and two sided 95% confidence intervals. Consequently, this group would only include fathers who started a new antidepressant treatment during pregnancy, because fathers on a stable long term treatment regimen were likely to have overlapped the eight week conception period. DESIGN Observational prospective cohort study with regression methods, and negative control comparison. Clipboard, Search History, and several other advanced features are temporarily unavailable. Bookshelf We do not capture any email address. Malformation at birth was identified in the Medical Birth Register (eTable 3), based on a binary variable including any malformation according to ICD-10 (international classification of diseases, 10th revision) codes Q00-99.34 Clinically ascertained ICD-10 diagnoses of autism spectrum disorder and intellectual disability were identified from birth to 31 December 2014 in the Swedish National Patient Register,4142 which includes dates of all inpatient psychiatric admissions since 1973 and all outpatient specialist visits since 2001 (eTable 3).41. on PubMed Central. For example, a father who received antidepressant treatment in the two years before conception but who stopped treatment five weeks before conception would be classified as a non-user, and a father not receiving treatment until three weeks after conception would be classified as being exposed to antidepressants during conception. But if it doesn't relieve your symptoms or it causes side effects that bother you, you may need to try another. Participants: Takeaway. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. presented in this activity is not meant to serve as a guideline for patient management. Mission To lead the debate on healthcare and to deliver innovative, useful evidence based knowledge, best practice and learning to doctors, other health professionals, researchers and patients when and where they need it. Front Psychiatry. JAMA Psychiatry 2018;75:176-84. Erectile dysfunction (ED) is often a symptom . Based on Danish national registers . In the present study, autism was diagnosed in 0.9% of children and intellectual disability in 0.5% of children during the follow-up period of the first seven to eight years after birth, which is similar to the prevalence of 0.6% for both autism and intellectual disability in children aged 3-10 years in a recent American survey49 and prevalence estimates from register based sources in other Scandinavian cohorts.50 Similar to a previous study by Yang and colleagues,21 we observed an association between paternal antidepressant treatment during conception and autism when potential confounders were not adjusted for, and an attenuation of the association when confounders were adjusted for. Cohort characteristics, by exposure group, Parental psychiatric disorders diagnosed in the Swedish National Patient Register before childbirth or throughout 2014, by exposure group. Symptoms of ED include. a fully "online first" publication. 10.1001/jamapsychiatry.2013.4081 Description of exposure periods. Currently, limited evidence is available on the efficacy of continuing versus discontinuing antidepressant treatment during pregnancy to aid their decision. As such, cohort members were not involved in setting the research question or the outcome measures, nor were they involved in developing plans for the design or implementation of the study. Data management was performed by SAS 9.4, and STATA/IC 14 was used for logistic regression (command logistic) and Cox regression (command stcox). Contributors: SS initiated the collaborative project. Objective To examine the association between paternal antidepressant use at conception and offspring preterm birth, malformations, autism spectrum disorder, and intellectual disability. Paternal intake of antidepressants during the period around conception is safe with respect to the risk of the four major adverse outcomes in offspring preterm birth, malformation, autism, or intellectual disability. It is not anti-inflammatory and does not carry the risk. Third trimester. Other antidepressants. The website is updated eCollection 2020. being included in an issue of the print journal. Setting: In this Swedish population based study of 170508 children born in 2006-07 and followed up to the end of 2014, we investigated the effects of paternal antidepressant treatment during conception on offspring preterm birth, malformation, autism, and intellectual disability. SSRIs are helpful in alleviating the effects of depression but have side effects. Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declare: support from the National Institutes of Health, Beatrice and Samuel A Seaver Foundation, Fredrik and Ingrid Thuring Foundation, and Swedish Society of Medicine for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work. 2 Many studies have investigated the impacts of antidepressant use during pregnancy on perinatal outcomes and child development, 3 but the . Acetaminophen seems to be the safest option for a painkiller. Copyright 2023 BMJ Publishing Group Ltd, , professor of psychiatry and preventive medicine, , assistant professor of epidemiology and biostatistics, Advancing maternal age is associated with increasing risk for autism: a review and meta-analysis, A comprehensive assessment of parental age and psychiatric disorders, Association of maternal use of folic acid and multivitamin supplements in the periods before and during pregnancy with the risk of autism spectrum disorder in offspring, Autism risk following antidepressant medication during pregnancy, Association of antidepressant medication use during pregnancy with intellectual disability in offspring, Parental depression, maternal antidepressant use during pregnancy, and risk of autism spectrum disorders: population based case-control study, Associations of maternal antidepressant use during the first trimester of pregnancy with preterm birth, small for gestational age, autism spectrum disorder, and attention-deficit/hyperactivity disorder in offspring, Use of selective serotonin reuptake inhibitors during pregnancy and risk of autism, Antidepressant use during pregnancy and psychiatric disorders in offspring: Danish nationwide register based cohort study, Selective serotonin re-uptake inhibitor use during pregnancy: association with offspring birth size and gestational age, Use of antidepressants during pregnancy and risk of attention-deficit/hyperactivity disorder in the offspring, Antidepressants during pregnancy and autism in offspring: population based cohort study, Antidepressant exposure in pregnancy and risk of autism spectrum disorders, Use of antidepressants near delivery and risk of postpartum hemorrhage: cohort study of low income women in the United States. 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