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ADHD more common in children of fathers on SSRIs
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Children of men who used selective serotonin reuptake inhibitors before conception are 26% more likely to develop attention-deficit/hyperactivity disorder later in life, according to findings published in Pediatrics.
“Both genetic and environmental factors may be implicated in the development of ADHD, but its etiology remains unclear,” Fen Yang. from the Key Laboratory of National Population and Family Planning Commission at the Shanghai Institute of Planned Parenthood Research at Fudan University, Shanghai, China, and the department of clinical epidemiology at Aarhus University Hospital, Aarhus, Denmark, and colleagues wrote. “There is a growing body of literature documenting a wide variety of prenatal factors associated with an increased risk of ADHD (including maternal smoking, stress, alcohol and substance misuse and exposure to environmental toxins during pregnancy).”
“However, few researchers have examined the potential role of paternal factors in the development of ADHD,” the researchers continued.
To assess the connection between parental use of selective serotonin reuptake inhibitors (SSRIs) before conception and the offspring’s chance of developing ADHD, Yang and colleagues conducted a cohort study using Danish national registers. The study included children born between 1996 and 2008, and the children were followed up in 2013. Exposed children were defined as those whose fathers used SSRIs for the last 3 months before conception.
Of the 781,470 children born in the study period, 0.92% (n = 7,216) had paternal exposure to SSRIs; however, 12,520 were diagnosed with ADHD. Those who were paternally exposed to SSRIs were 26% more likely to receive this diagnosis when adjusted for possible confounders (HR = 1.26; 95% CI, 1.06-1.51). When the exposure period was lengthened to 1 year before conception, an increased risk was noted when SSRIs were used 12 to 3 months before conception (HR = 1.35; 95% CI, 1.10-1.66).
A similar risk was observed by the researchers when fathers used SSRIs within 3 months of conception (adjusted HR = 1.31; 95% CI, 0.95-1.82).
“Confounding by indication poses the main challenge in this study because the underlying paternal mental health disease itself could be a possible risk factor for ADHD,” Yang and colleagues wrote. “… The results of these analyses suggested that paternal psychiatric illness rather than SSRI exposure might be associated with ADHD liability, consistent with previous studies in which researchers observed the link between parental psychiatric disorder and offspring ADHD.” – by Katherine Bortz
Disclosures: The authors report no relevant financial disclosures.
Perspective
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Paul H. Lipkin , MD
There are ongoing debates about the influences of SSRI exposure and paternal age on the developing fetus, particularly around the diagnosis of autism spectrum disorders. In this paper, researchers took a similar look at these in a more common developmental disorder: attention-deficit/hyperactivity disorder (ADHD).
This elegant paper, analyzing data from a group of Danish registries, focuses on paternal prenatal SSRI use. The investigators found a greater influence of a father’s preconception SSRI use than use during the vulnerable conception period (3 months). This lends further interest and data to our understanding of the influences of comorbid health conditions in fathers and prenatal drug exposures on the developing fetus with childhood neurodevelopmental conditions.
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