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School-age social behavior and pragmatic language ability in children with prenatal serotonin reuptake inhibitor exposure

Published online by Cambridge University Press:  07 February 2019

Erica L. Smearman*
Affiliation:
Department of Psychology, Emory University, Atlanta, GA, USA Medical Scientist Training Program, Emory University School of Medicine, Atlanta, GA, USA
Cassandra L. Hendrix
Affiliation:
Department of Psychology, Emory University, Atlanta, GA, USA
Dominika A. Winiarski
Affiliation:
Section of Population Behavioral Health, Rush University Medical Center, Chicago, IL, USA
Katrina C. Johnson
Affiliation:
Department of Psychology, Emory University, Atlanta, GA, USA
Alicia K. Smith
Affiliation:
Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA Department of Gynecology & Obstetrics, Emory University, Atlanta, GA, USA
Opal Y. Ousley
Affiliation:
Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA
Zachary N. Stowe
Affiliation:
Department of Psychiatry, University of Wisconsin, Madison, WI, USA
D. Jeffrey Newport
Affiliation:
Departments of Psychiatry & Behavioral Sciences and Obstetrics & Gynecology, University of Miami Miller School of Medicine, Miami, FL, USA
Patricia A. Brennan
Affiliation:
Department of Psychology, Emory University, Atlanta, GA, USA
*
Author for correspondence: Erica L. Smearman, Department of Psychology, 36 Eagle Row, Emory University, Atlanta, GA30322. E-mail: esmearm@emory.edu

Abstract

Studies examining associations between fetal serotonin reuptake inhibitor (SRI) exposure and child autism spectrum disorder (ASD) diagnoses or delayed language remain mixed and rarely prospectively follow children or employ gold-standard assessments. We prospectively followed a cohort of mother–child dyads from pregnancy through early elementary school (N = 178), and obtained maternal and alternate–caregiver ratings of behaviors related to ASD (N = 137), as well as direct, gold-standard assessments of child ASD symptoms and pragmatic language among dyads who experienced prenatal depression and either took SRIs or were medication free during pregnancy (N = 44). Prenatal SRI exposure was related to maternal ratings of ASD-related behaviors (β = 0.24 95% confidence interval; CI [0.07, 0.48]), and, among boys, alternative caregiver ratings (males-only β = 0.28 95% CI [0.02, 0.55], females-only β = −0.21 95% CI [–0.63, 0.08]). However, results of our direct assessments suggest an association between SRI exposure and reduced pragmatic language scores (β = –0.27, 95% CI [–0.53, –0.01], but not ASD (Autism Diagnostic Observation Schedule β = 0.14 95% CI [–0.15, 0.41]; Social Responsiveness Scale β = 0.08 95% CI [–0.25, 0.40]). These discrepancies point to issues regarding how ASD is assessed, and the possibility that SRIs may be more strongly associated with language or other broader behaviors that coincide with ASD. Larger prospective studies that incorporate thorough, gold-standard assessments of ASD, language, and other ASD-related behaviors are needed.

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Regular Articles
Copyright
Copyright © Cambridge University Press 2019

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