Prenatal Paternal Selective Serotonin Reuptake Inhibitors Use and Risk of ADHD in Offspring

Pediatrics. 2018 Jan;141(1):e20171081. doi: 10.1542/peds.2017-1081. Epub 2017 Dec 11.

Abstract

Objectives: It has been shown that maternal prenatal exposure to selective serotonin reuptake inhibitors (SSRIs) may be a risk factor for attention-deficit/hyperactivity disorder (ADHD) in offspring. Our goal was to examine whether paternal SSRI use before conception increases the risk of ADHD in offspring.

Methods: On the basis of Danish national registers, we conducted a cohort study of 781 470 singletons born between 1996 and 2008 with follow-up throughout 2013. The children whose fathers used SSRIs during the last 3 months before conception were identified as the exposed. Cox regression was used to estimate the hazard ratio (HR) of ADHD.

Results: A total of 7216 children (0.92%) were born to fathers who had used SSRIs during the last 3 months before conception. There were 12 520 children diagnosed with ADHD. Compared with unexposed children, the exposed had a 26% increased risk of ADHD (HR = 1.26, 95% confidence interval [CI]: 1.06-1.51) after adjusting for potential confounders. When extending the exposure window to 1 year before conception, paternal use of SSRIs only during the period of 12 to 3 months before conception was associated with the HR of 1.35 (95% CI: 1.10-1.66), whereas paternal use of SSRIs only during the last 3 months before conception was associated with a similarly increased risk of ADHD (adjusted HR = 1.31, 95% CI: 0.95-1.82).

Conclusions: The mildly increased risk of ADHD in offspring associated with paternal SSRI use before conception could probably be due to the underlying indications related to SSRI use.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Attention Deficit Disorder with Hyperactivity / chemically induced*
  • Attention Deficit Disorder with Hyperactivity / epidemiology
  • Child
  • Child, Preschool
  • Cohort Studies
  • Confidence Intervals
  • Denmark
  • Female
  • Humans
  • Incidence
  • Infant
  • Infant, Newborn
  • Male
  • Paternal Exposure / adverse effects*
  • Pregnancy
  • Prenatal Exposure Delayed Effects / chemically induced*
  • Prenatal Exposure Delayed Effects / epidemiology
  • Proportional Hazards Models
  • Registries*
  • Risk Assessment
  • Serotonin Uptake Inhibitors / administration & dosage
  • Serotonin Uptake Inhibitors / adverse effects*
  • Sex Factors

Substances

  • Serotonin Uptake Inhibitors