ADHD Risk in Offspring of Fathers Taking SSRIs Before, At Conception

According to the results of a study published in Pediatrics, paternal selective serotonin reuptake inhibitor (SSRI) use was associated with a mildly increased risk for attention-deficit/hyperactivity disorder (ADHD) in offspring, regardless of whether SSRI use was 12 to 3 months before conception or during the 3 months before conception. The researchers hypothesize that this increased risk may be caused by underlying indications related to SSRI use.

In a cohort study of 781,470 singletons born between 1996 and 2008 gathered from Danish national registries, children were monitored for hospital-based diagnoses of ADHD through 2013. Infants were considered exposed if paternal SSRI use occurred during the last 3 months before conception. In additional analyses, researchers evaluated the impact of SSRI use during the last year before conception. The association of offspring ADHD and SSRI use was evaluated with Cox regression analyses.

A total of 0.92% of participants were exposed to paternal SSRIs during the last 3 months prior to conception. ADHD diagnoses were reported for 12,520 children in the study (median age at diagnosis 8.56 years). Children whose fathers used SSRIs during the 3 months prior to conception were at an increased risk for ADHD compared with unexposed children (hazard ratio [HR] 1.26) after adjusting for confounders, including paternal psychiatric history. In a propensity-score matched subgroup analysis, paternal SSRI use was still associated with ADHD in offspring (HR 1.36).

Former paternal SSRI use during 3 to 12 months before conception was associated with an increased risk for ADHD in offspring (HR 1.35) as was current use in the last 3 months (HR 1.31). In sibling comparisons (n=6409), the risk for ADHD in exposed children was lower compared with unexposed siblings (HR 0.68).

According to the study authors, these data indicate that the increased risk for ADHD in offspring, “could apparently be a result of confounding by paternal psychopathology.”

The study authors concluded that, “paternal SSRI use before conception was associated with a mildly increased risk [for] ADHD in offspring, especially in the former users who took SSRIs before the susceptible exposure period…. Paternal underlying indications related to SSRI use or other confounding factors may explain the increased risk.”

Reference

Yang F, Liang H, Chen J, et al. Prenatal paternal selective serotonin reuptake inhibitors use and risk of ADHD in offspring. Pediatrics. 2018;141(1).