TY - JOUR
T1 - Paternal use of antidepressants and offspring outcomes in Sweden
T2 - Nationwide prospective cohort study
AU - Viktorin, Alexander
AU - Levine, Stephen Z.
AU - Altemus, Margret
AU - Reichenberg, Abraham
AU - Sandin, Sven
N1 - Funding Information: This study was supported by grants from the National Institutes of Health; grant HD073978 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institute of Environmental Health Sciences, and National Institute of Neurological Disorders and Stroke; grant MH097849 from the National Institute of Mental Health; the Beatrice and Samuel A Seaver Foundation (SS is a Seaver Faculty Scholar); the Fredrik and Ingrid Thuring Foundation (AV); and the Swedish Society of Medicine (AV). No funder had any role in the study design; data collection, analysis, or interpretation; in the writing of the report; or in the decision to submit the article for publication. The views expressed are those of the authors and not necessarily those of the funders, or the organisations they represent. Funding Information: Contributors: SS initiated the collaborative project. AV, AR, and SS collected, assembled, and quality controlled the data. SS and AR are the guarantors. AV, MA, SZL, and SS conceived and designed the study and wrote the statistical analysis plan before the start of data analysis. AV developed the statistical analysis programs and analysed the data. AV and SS drafted the first version of the report. All authors analysed and interpreted the data. All authors contributed to the content and critical revision of the report and agreed to submit the report for publication. The corresponding author attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted. Funding: This study was supported by grants from the National Institutes of Health; grant HD073978 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institute of Environmental Health Sciences, and National Institute of Neurological Disorders and Stroke; grant MH097849 from the National Institute of Mental Health; the Beatrice and Samuel A Seaver Foundation (SS is a Seaver Faculty Scholar); the Fredrik and Ingrid Thuring Foundation (AV); and the Swedish Society of Medicine (AV). No funder had any role in the study design; data collection, analysis, or interpretation; in the writing of the report; or in the decision to submit the article for publication. The views expressed are those of the authors and not necessarily those of the funders, or the organisations they represent. Publisher Copyright: © Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to.
PY - 2018
Y1 - 2018
N2 - Objective: To examine the association between paternal antidepressant use at conception and offspring preterm birth, malformations, autism spectrum disorder, and intellectual disability. Design: Observational prospective cohort study with regression methods, and negative control comparison. Setting: Sweden nationwide. Participants: 170 508 children conceived from 29 July 2005 and born in 2006-07, followed up to 2014 at age 8-9 years. This cohort included 3983 children born to fathers receiving antidepressant treatment during the conception period (that is, from four weeks before conception to four weeks after), a control group of 164 492 children not exposed to paternal antidepressant use, and a negative control comparison group of 2033 children born to fathers who did not use antidepressants during the conception period but began antidepressant treatment later during the pregnancy period (that is, from four weeks after conception to childbirth). Main outcome measure: Offspring preterm birth, malformation diagnosed at birth, diagnosis of autism spectrum disorder, and diagnosis of intellectual disability. Results: Paternal antidepressant use during conception was not associated with preterm birth (adjusted odds ratio 0.91 (95% confidence interval 0.79 to 1.04)) or malformations (1.06 (0.90 to 1.26)) using logistic regression, compared with offspring born to unexposed fathers. 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. In children whose fathers initiated antidepressant treatment during pregnancy, results were similar for all outcomes apart from intellectual disability, which had an increased adjusted hazard ratio (1.66 (1.06 to 2.59)). Compared with the 2033 children whose fathers initiated antidepressant treatment during pregnancy, the 3983 children exposed to paternal use of antidepressants at conception had no differences in preterm birth, malformation, and autism, but a reduced risk of intellectual disability (adjusted hazard ratio 0.49 (0.26 to 0.93)). Conclusion: 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.
AB - Objective: To examine the association between paternal antidepressant use at conception and offspring preterm birth, malformations, autism spectrum disorder, and intellectual disability. Design: Observational prospective cohort study with regression methods, and negative control comparison. Setting: Sweden nationwide. Participants: 170 508 children conceived from 29 July 2005 and born in 2006-07, followed up to 2014 at age 8-9 years. This cohort included 3983 children born to fathers receiving antidepressant treatment during the conception period (that is, from four weeks before conception to four weeks after), a control group of 164 492 children not exposed to paternal antidepressant use, and a negative control comparison group of 2033 children born to fathers who did not use antidepressants during the conception period but began antidepressant treatment later during the pregnancy period (that is, from four weeks after conception to childbirth). Main outcome measure: Offspring preterm birth, malformation diagnosed at birth, diagnosis of autism spectrum disorder, and diagnosis of intellectual disability. Results: Paternal antidepressant use during conception was not associated with preterm birth (adjusted odds ratio 0.91 (95% confidence interval 0.79 to 1.04)) or malformations (1.06 (0.90 to 1.26)) using logistic regression, compared with offspring born to unexposed fathers. 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. In children whose fathers initiated antidepressant treatment during pregnancy, results were similar for all outcomes apart from intellectual disability, which had an increased adjusted hazard ratio (1.66 (1.06 to 2.59)). Compared with the 2033 children whose fathers initiated antidepressant treatment during pregnancy, the 3983 children exposed to paternal use of antidepressants at conception had no differences in preterm birth, malformation, and autism, but a reduced risk of intellectual disability (adjusted hazard ratio 0.49 (0.26 to 0.93)). Conclusion: 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.
UR - http://www.scopus.com/inward/record.url?scp=85048423337&partnerID=8YFLogxK
U2 - https://doi.org/10.1136/bmj.k2233
DO - https://doi.org/10.1136/bmj.k2233
M3 - Article
C2 - 29884724
SN - 0959-8146
VL - 361
JO - The BMJ
JF - The BMJ
M1 - k2233
ER -