Unit of Epidemiology and Biostatistics, Aalborg University Hospital, Aalborg, Denmark.
Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark.
Acta Psychiatr Scand. 2018 Jun;137(6):481-490. doi: 10.1111/acps.12867. Epub 2018 Feb 25.
Data on special education in offspring exposed to selective serotonin reuptake inhibitors (SSRIs) in utero are lacking. We examined associations of in utero SSRI exposure with special education needs and delayed elementary school start.
A population-based case-cohort study using Danish nationwide birth and prescription registry data from 2005 to 2008. Follow-up ends during 2011-2015 to capture special education needs during and delayed entry to the first elementary school year. Cases were in utero SSRI-exposed offspring. Cohort-controls were SSRI-unexposed offspring of mothers previously on SSRIs. We reported odds ratios (ORs) and 95% confidence intervals (CIs), adjusted for relevant potential confounders.
Of 117 475 first-incident non-multiple pregnancy births, 3314 were SSRI-exposed, and 3536 were unexposed. Among SSRI-exposed offspring, 3.2% (n = 98) had special school needs vs. 2.4% (n = 77) in unexposed offspring, P-value=0.048. Correspondingly, 12.3% (n = 383) among SSRI-exposed children had delayed school entry vs. 9.4% (n = 308) in unexposed offspring, P-value < 0.001. Adjusted OR for the association with special school needs was 1.12 (95% CI 0.82-1.55; P-value = 0.48) and 1.38 (95% CI 0.90-2.13; P-value = 0.14) for exposure in all three trimesters. The corresponding adjusted ORs for delayed school entry were 1.17 (95% CI 0.99-1.38; P-value = 0.073) and 1.40 (95% CI 1.11-1.76; P-value = 0.004).
In utero SSRI exposure in all three trimesters was associated with delayed elementary school start but not special education needs.
关于在子宫内暴露于选择性 5-羟色胺再摄取抑制剂（SSRIs）的后代的特殊教育的数据尚缺乏。我们研究了子宫内 SSRI 暴露与特殊教育需求和延迟小学入学之间的关联。
一项基于人群的病例-队列研究，使用丹麦全国 2005 年至 2008 年的出生和处方登记数据。随访截止于 2011-2015 年，以捕捉特殊教育需求和延迟进入第一个小学年级。病例为子宫内 SSRI 暴露的后代。队列对照为之前使用 SSRIs 的母亲的未暴露 SSRI 后代。我们报告了比值比（OR）和 95％置信区间（CI），调整了相关潜在混杂因素。
在 117475 例首次非多胎妊娠出生中，有 3314 例为 SSRI 暴露，3536 例为未暴露。在 SSRI 暴露的后代中，有 3.2％（n=98）有特殊学校需求，而未暴露的后代为 2.4％（n=77），P 值=0.048。相应地，在 SSRI 暴露的儿童中，有 12.3％（n=383）延迟入学，而未暴露的儿童为 9.4％（n=308），P 值<0.001。调整后的关联特殊学校需求的 OR 为 1.12（95％CI 0.82-1.55；P 值=0.48）和 1.38（95％CI 0.90-2.13；P 值=0.14），暴露于所有三个三个月。延迟入学的相应调整后 OR 为 1.17（95％CI 0.99-1.38；P 值=0.073）和 1.40（95％CI 1.11-1.76；P 值=0.004）。
在所有三个三个月中，子宫内 SSRI 暴露与延迟小学入学有关，但与特殊教育需求无关。
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