Study Debunks Association Between In Utero Antidepressant Exposure and ADHD Risk

The investigators suggested that future research explore the connection between ADHD risk in children and depression in pregnant parents.

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A study found that there may be no association between in utero antidepressant exposure and development of attention-deficit/hyperactivity disorder (ADHD) in children.

Because recent research has reported an association between antidepressant use in the pregnant parent and subsequent risk of ADHD in the child, the investigators' goal was to explore this association as well as any confounding risk factors in the pregnant parent. Investigators developed a case-control sibling study using prescription data from the University of Groningen prescription database IADB.nl. The study included prescription data for 65,251 infants and their childbearing parents who were born between 1995 and 2020.1

Cases (N=1304) consisted of children who had received ADHD medication before the age of 16 years, and controls (N=1529) consisted of siblings matched to the cases who had not received ADHD medication. Investigators analyzed data for an overall total of 2833 children, with antidepressant exposure rate at 2.2% and 2.4% for cases and controls, respectively.1

In addition to the main analysis, the investigators performed secondary analyses to assess the degree and type of antidepressant exposure, and estimated odds ratios with corresponding 95% confidence intervals (CIs) using univariate and multivariate logistic regression. They adjusted for the child’s birth rate, the pregnant parent’s age at the time of the child’s birth, and the pregnant parent’s use of opioids, psychostimulants, and antiepileptic drugs during the 15 months prior to the child’s birth.1

This resulted in an adjusted odds ratio of 1.11 (95% CI 0.67-1.83) for the risk of ADHD in the children when they were exposed to in utero antidepressants. The secondary analyses also yielded no statistically significant associations. Together, this indicates no increased risk of ADHD development in regard to exposure to antidepressants in utero.1

The investigators suggested that depression—rather than use of antidepressants specifically—in the pregnant parent may play a role in the development of ADHD and other mental disorders in children. “The present study provides further evidence that an association between in utero antidepressant exposure and ADHD in offspring might not exist, but that this perceived association may be caused (at least partially) by confounding by indication,” they concluded.

“The extent to which depression in the pregnant parent could cause mental disorders such as ADHD in offspring, and the mechanisms involved should be investigated in further studies, preferably using diagnostic data on both depression in the pregnant parent as well as on ADHD in the offspring.”1

Reference

1. Hartwig CAM, Robiyanto R, de Vos S, et al. In utero antidepressant exposure not associated with ADHD in the offspring: a case control sibling designFront Pharmacol. 2022;13:1000018.

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