Selective Serotonin Reuptake Inhibitor (SSRI) updated on 07-01-2025

ASD (Autism spectrum disorder): Diagnosis/Risk

R analysis
id Study   Lib. in paper Exposition period    Study type 
 Control type 
 
Tags OR 95%CI x1/n1 x0/n0 no cases no exposed ROB Ref.
S17443
R76854		 Lee (Controls unexposed, general pop), 2024 Autism spectrum disorder - ICD-9 code 299, ICD-10 code F84 - Follow up 1-13 years 1st and 2nd trimester population based cohort retrospective unexposed (general population or NOS) Adjustment: Yes Monotherapy: no or not specified 1.06 [0.82;1.38] 84/6,146   21,947/2,245,689 22,031 6,146
ref
S17444
R76855		 Lee (Controls unexposed, sibling), 2024 Autism spectrum disorder - ICD-9 code 299, ICD-10 code F84 - Follow up 1-13 years 1st and 2nd trimester population based cohort retrospective sibling excluded Adjustment: Yes Monotherapy: no or not specified 0.89 [0.45;1.77]
excluded (control group) 		-/2,458   -/2,948 - 2,458
ref
S15000
R61411		 Brennan, 2023 Autism spectrum disorder (ASD) diagnosis - 1 to 12 years of age during pregnancy (anytime or not specified) retrospective cohort unexposed (general population or NOS) Adjustment: No Monotherapy: no or not specified 1.50 [0.60;3.50] -/-   -/- - -
ref
S18372
R77506		 Heuvelman, 2023 Autism spectrum disorder - Validated Read code list among primary care clinical and referral records - Mean age at end of follow-up 10.04 years, range 4–22 years during pregnancy (anytime or not specified) retrospective cohort (claims database) unexposed, sick Adjustment: Yes Monotherapy: no or not specified Partial overlapping Unexposed sick: intermediate history of illness/treatment (3-12 months before pregnancy) 1.26 [1.04;1.53] -/12,093   -/16,330 - 12,093
ref
S17049
R76862		 Suarez (Controls unexposed, discontinuers), 2022 Autism Spectrum Disorder - ≥ 2 dates with ICD-9 Dx 299.xx (except 299.1x) - At ≥ 1 year of age 2nd and/or 3rd trimester retrospective cohort (claims database) unexposed, sick Adjustment: Yes Monotherapy: no or not specified Unexposed sick: recent illness/treatment (during or juste before pregnancy or treatment stopped in view of pregnancy) 1.17 [0.99;1.39] 809/115,060   221/38,038 1,030 115,060
ref
S17050
R76863		 Suarez (Controls unexposed, general pop), 2022 Autism Spectrum Disorder - ≥ 2 dates with ICD-9 Dx 299.xx (except 299.1x) - At ≥ 1 year of age 2nd and/or 3rd trimester retrospective cohort (claims database) unexposed (general population or NOS) excluded Adjustment: Yes Monotherapy: no or not specified 1.08 [0.98;1.19]
excluded (control group) 		809/115,110   11,443/3,000,907 12,252 115,110
ref
S10002
R46770		 Ames (Controls unexposed, disease free), 2021 Autism spectrum disorder (ASD): diagnostic criteria on the Autism Diagnostic Observation Schedule and the full ASD diagnostic criteria on the ADI-R or one of three alternative criteria on the ADI-R (age NOS). during pregnancy (anytime or not specified) case control unexposed, disease free excluded Adjustment: Yes Monotherapy: no or not specified 2.05 [1.50;2.80]
excluded (control group) 		115/196   1,252/2,842 1,367 196
ref
S10003
R46771		 Ames (Controls unexposed, sick), 2021 Autism spectrum disorder (ASD): diagnostic criteria on the Autism Diagnostic Observation Schedule and the full ASD diagnostic criteria on the ADI-R or one of three alternative criteria on the ADI-R (age NOS). during pregnancy (anytime or not specified) case control unexposed, sick Adjustment: Yes Monotherapy: no or not specified Unexposed sick: recent illness/treatment (during or juste before pregnancy or treatment stopped in view of pregnancy) 1.14 [0.80;1.62] 115/196   -/- - 196
ref
S7838
R46779		 Hagberg (Controls exposed to TCA), 2018 Autism spectrum disorder (diagnostic code including codes for autism, Asperger’s syndrome, and pervasive developmental disorder (PDD)) - Median diagnosis 5.8 years during pregnancy (anytime or not specified) retrospective cohort (claims database) exposed to other treatment, sick excluded Adjustment: No Monotherapy: SSRI only Partial overlapping 0.83 [0.66;1.05] C
excluded (control group) 		292/17,362   98/4,856 390 17,362
ref
S7837
R46780		 Hagberg (Controls unexposed, disease free), 2018 Autism spectrum disorder (diagnostic code including codes for autism, Asperger’s syndrome, and pervasive developmental disorder (PDD)) - Median diagnosis 5.8 years during pregnancy (anytime or not specified) retrospective cohort (claims database) unexposed, disease free excluded Adjustment: Yes Matched Monotherapy: SSRI only Partial overlapping 1.68 [1.46;1.92]
excluded (control group) 		292/17,362   1,500/154,107 1,792 17,362
ref
S7836
R46781		 Hagberg (Controls unexposed, sick), 2018 Autism spectrum disorder (diagnostic code including codes for autism, Asperger’s syndrome, and pervasive developmental disorder (PDD)) - Median diagnosis 5.8 years during pregnancy (anytime or not specified) retrospective cohort (claims database) unexposed, sick Adjustment: No Monotherapy: SSRI only Partial overlapping Unexposed sick: intermediate history of illness/treatment (3-12 months before pregnancy) 1.12 [0.93;1.34] C 292/17,362   196/12,994 488 17,362
ref
S483
R46774		 Brown, 2017 Autism spectrum disorder (ASD) Diagnostic (ICD-9/OHIP: 299; ICD-10: F84) - Age: 4-10 years (mean: 4.95 years) during pregnancy (anytime or not specified) retrospective cohort (claims database) unexposed (general population or NOS) Adjustment: Yes Monotherapy: no or not specified 1.40 [0.80;2.46] -/-   -/- - -
ref
S7551
R46783		 Liu, 2017 Autism spectrum disorder (ICD-10 codes F84.0, F84.1, F84.5, F84.8, or F84.9) in the offspring (mean age at diagnosis: 8.5 years) during pregnancy (anytime or not specified) population based cohort retrospective unexposed, sick Adjustment: Yes Monotherapy: SSRI only Unexposed sick: old history of illness/treatment (> 12 months before pregnancy) or not specified 1.19 [0.96;1.48] 125/13,501   257/30,079 382 13,501
ref
S11132
R46787		 Rai (Controls exposed to TCA), 2017 Autism spectrum disorder (ICD-9 (299), ICD-10 (F84), or DSM-IV (299) codes) - At 4-17 years during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick excluded Adjustment: No Monotherapy: SSRI only 0.55 [0.32;0.95] C
excluded (control group) 		105/2,710   16/235 121 2,710
ref
S7480
R46788		 Rai (Controls unexposed, disease free), 2017 Autism spectrum disorder (ICD-9 (299), ICD-10 (F84), or DSM-IV (299) codes) - At 4-17 years during pregnancy (anytime or not specified) prospective cohort unexposed, disease free excluded Adjustment: No Monotherapy: SSRI only 1.93 [1.58;2.35] C
excluded (control group) 		105/2,710   4,889/238,943 4,994 2,710
ref
S7824
R46789		 Rai (Controls unexposed, sick), 2017 Autism spectrum disorder (ICD-9 (299), ICD-10 (F84), or DSM-IV (299) codes) - At 4-17 years during pregnancy (anytime or not specified) prospective cohort unexposed, sick Adjustment: Yes Monotherapy: SSRI only Unexposed sick: old history of illness/treatment (> 12 months before pregnancy) or not specified 1.45 [1.14;1.83] 105/2,710   353/12,325 458 2,710
ref
S7549
R46790		 Sujan (Controls unexposed, NOS), 2017 Autism spectrum disorder (ICD9-10) - Cumulative risk by age 15 years (1-17years) 1st trimester population based cohort retrospective unexposed (general population or NOS) Adjustment: Yes Monotherapy: no or not specified 1.66 [1.46;1.89] 236/18,470   14,381/1,562,159 14,617 18,470
ref
S7840
R46791		 Sujan (Controls unexposed, sibling), 2017 Autism spectrum disorder (ICD9-10) - Cumulative risk by age 15 years (1-17years) 1st trimester population based cohort retrospective sibling excluded Adjustment: Yes Monotherapy: no or not specified Unexposed sick: old history of illness/treatment (> 12 months before pregnancy) or not specified 0.81 [0.58;1.14]
excluded (control group) 		108/9,063   229/15,906 337 9,063
ref
S7046
R46772		 Boukhris (Controls exposed to TCA), 2016 Autism spectrum disorder (ICD-9 codes 299.0, 299.8, 299.9; ICD-10 codes F84.0, F84.1, F84.5, F84.8, F84.9) - End follow-up: mean 6.2 years (median 7.0 years) 2nd and/or 3rd trimester retrospective cohort (claims database) exposed to other treatment, sick excluded Adjustment: No Monotherapy: SSRI only 1.60 [0.37;6.85] C
excluded (control group) 		22/1,583   2/229 24 1,583
ref
S481
R46773		 Boukhris (Controls unexposed, NOS), 2016 Autism spectrum disorder (ICD-9 codes 299.0, 299.8, 299.9; ICD-10 codes F84.0, F84.1, F84.5, F84.8, F84.9) - End follow-up: mean 6.2 years (median 7.0 years) 2nd and/or 3rd trimester retrospective cohort (claims database) unexposed (general population or NOS) Adjustment: Yes Monotherapy: SSRI only 2.17 [1.20;3.93] 22/1,583   1,023/142,924 1,045 1,583
ref
S6463
R46784		 Malm (Controls unexposed, disease free), 2016 Autism Spectrum Disorder (Hospital Discharge Register - F84, but excluding Rett's syndrome, F84.2) - At 0-14 years old during pregnancy (anytime or not specified) population based cohort retrospective unexposed, disease free excluded Adjustment: Yes Monotherapy: no or not specified 1.40 [1.02;1.92]
excluded (control group) 		-/15,729   -/31,394 - 15,729
ref
S5401
R46785		 Malm (Controls unexposed, sick), 2016 Autism Spectrum Disorder (Hospital Discharge Register - F84, but excluding Rett's syndrome, F84.2) - At 0-14 years old during pregnancy (anytime or not specified) population based cohort retrospective unexposed, sick Adjustment: Yes Monotherapy: no or not specified Unexposed sick: intermediate history of illness/treatment (3-12 months before pregnancy) 0.88 [0.65;1.20] -/15,729   -/9,651 - 15,729
ref
S473
R46775		 Clements, 2015 Autism spectrum disorder (ICD-9 code 299 (pervasive developmental disorder)) - At 2–19 years (mean diagnosis: 5.1 years) during pregnancy (anytime or not specified) case control unexposed (general population or NOS) Adjustment: Yes Matched Monotherapy: no or not specified 1.02 [0.62;1.65] 33/101   1,344/5,298 1,377 101
ref
S5402
R46786		 Man, 2015 Autism spectrum disorder (NOS) - Age not specified during pregnancy (anytime or not specified) case control unexposed (general population or NOS) Adjustment: Yes Monotherapy: no or not specified 1.35 [0.94;1.93] 37/1,794   4,171/295,172 4,208 1,794
ref
S480
R46794		 El Marroun (Control unexposed, disease free), 2014 Pervasive developmental problems (Parent-reported subscale of the Child Behavior Checklist for ages 1.5–6 (above the 93rd percentile)) during pregnancy (anytime or not specified) prospective cohort unexposed, disease free excluded Adjustment: Yes Monotherapy: no or not specified 1.91 [1.13;3.47]
excluded (control group) 		-/69   -/5,531 - 69
ref
S6591
R46795		 El Marroun (Control unexposed, sick), 2014 Pervasive developmental problems (Parent-reported subscale of the Child Behavior Checklist for ages 1.5–6 (above the 93rd percentile)) during pregnancy (anytime or not specified) prospective cohort unexposed, sick Adjustment: Yes Monotherapy: no or not specified Unexposed sick: recent illness/treatment (during or juste before pregnancy or treatment stopped in view of pregnancy) 1.33 [0.68;2.57] -/69   -/376 - 69
ref
S482
R46782		 Harrington, 2014 Autism spectrum disorder (Autism Diagnostic Interview–Revised (ADI-R) and the Autism Diagnostic Observation Schedule (ADOS)) - Mean 3.7 years (2-5 years) during pregnancy (anytime or not specified) case control unexposed (general population or NOS) Adjustment: Yes Matched Monotherapy: no or not specified 1.55 [0.59;4.08] 29/40   463/772 492 40
ref
S484
R46778		 Eriksson, 2012 Autism spectrum disorder (diagnosis) (20–54-month-old) during pregnancy (anytime or not specified) case control unexposed (general population or NOS) Adjustment: No Monotherapy: no or not specified 4.45 [2.19;9.05] 8/1,722   180/171,856 188 1,722
ref
S474
R46776		 Croen, 2011 Autism spectrum disorder (autism (ICD-9-CM code 299.0), Asperger syndrome (ICD-9-CM code 299.8), or pervasive developmental disorder not otherwise specified (ICD-9-CM code 299.8)) - Age: median 3-4 years 1st trimester nested case control unexposed (general population or NOS) Adjustment: Yes Matched Monotherapy: no or not specified 3.50 [1.50;7.90] 14/33   284/1,772 298 33
ref
Total 18 studies 1.32 [1.16;1.50] 46,614 206,609
x1: number of endpoints among exposed, n1: number of exposed; x0: number of endpoints among non exposed, n0: number of non exposed; C: calculated odds ratio from numbers of events and effectives

Forest plot

StudyTE95% CIn casesn exposedweightROBABCDEF Lee (Controls unexposed, general pop), 2024Lee, 2024 1 1.06[0.82; 1.38]22,0316,1467%ROB confusion: criticalROB selection: lowROB classification: criticalROB missing: unclearROB mesure: criticalROB reporting: moderate Brennan, 2023Brennan, 2023 1.50[0.60; 3.50]--2%ROB confusion: seriousROB selection: unclearROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: moderate Heuvelman, 2023Heuvelman, 2023 1.26[1.04; 1.53]-12,0939%ROB confusion: seriousROB selection: lowROB classification: moderateROB missing: criticalROB mesure: criticalROB reporting: low Suarez (Controls unexposed, discontinuers), 2022Suarez, 2022 2 1.17[0.99; 1.39]1,030115,0609%ROB confusion: seriousROB selection: lowROB classification: moderateROB missing: lowROB mesure: criticalROB reporting: moderate Ames (Controls unexposed, sick), 2021Ames, 2021 3 1.14[0.80; 1.62]-1966%ROB confusion: seriousROB selection: criticalROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Hagberg (Controls unexposed, sick), 2018Hagberg, 2018 4 1.12[0.93; 1.34]48817,3629%ROB confusion: unclearROB selection: lowROB classification: criticalROB missing: moderateROB mesure: moderateROB reporting: moderate Brown, 2017Brown, 2017 1.40[0.80; 2.46]--3%ROB confusion: seriousROB selection: moderateROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Liu, 2017Liu, 2017 1.19[0.96; 1.48]38213,5018%ROB confusion: seriousROB selection: lowROB classification: criticalROB missing: lowROB mesure: criticalROB reporting: moderate Rai (Controls unexposed, sick), 2017Rai, 2017 5 1.45[1.14; 1.83]4582,7108%ROB confusion: unclearROB selection: lowROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Sujan (Controls unexposed, NOS), 2017Sujan, 2017 6 1.66[1.46; 1.89]14,61718,47010%ROB confusion: seriousROB selection: lowROB classification: moderateROB missing: lowROB mesure: criticalROB reporting: moderate Boukhris (Controls unexposed, NOS), 2016Boukhris, 2016 7 2.17[1.20; 3.93]1,0451,5833%ROB confusion: seriousROB selection: lowROB classification: moderateROB missing: unclearROB mesure: criticalROB reporting: moderate Malm (Controls unexposed, sick), 2016Malm, 2016 8 0.88[0.65; 1.20]-15,7297%ROB confusion: moderateROB selection: lowROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: moderate Clements, 2015Clements, 2015 1.02[0.62; 1.65]1,3771014%ROB confusion: seriousROB selection: criticalROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: moderate Man, 2015Man, 2015 1.35[0.94; 1.93]4,2081,7946%ROB confusion: unclearROB selection: criticalROB classification: criticalROB missing: unclearROB mesure: criticalROB reporting: moderate El Marroun (Control unexposed, sick), 2014El Marroun, 2014 9 1.33[0.68; 2.57]-693%ROB confusion: seriousROB selection: lowROB classification: moderateROB missing: criticalROB mesure: criticalROB reporting: moderate Harrington, 2014Harrington, 2014 1.55[0.59; 4.08]492401%ROB confusion: criticalROB selection: criticalROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Eriksson, 2012Eriksson, 2012 4.45[2.19; 9.05]1881,7222%ROB confusion: criticalROB selection: criticalROB classification: lowROB missing: unclearROB mesure: moderateROB reporting: moderate Croen, 2011Croen, 2011 3.50[1.50; 7.90]298332%ROB confusion: seriousROB selection: lowROB classification: moderateROB missing: unclearROB mesure: criticalROB reporting: moderate Total (18 studies) I2 = 66% 1.32[1.16; 1.50]46,614206,6090.210.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Controls unexposed, general pop; 2: Controls unexposed, discontinuers; 3: Controls unexposed, sick; 4: Controls unexposed, sick; 5: Controls unexposed, sick; 6: Controls unexposed, NOS; 7: Controls unexposed, NOS; 8: Controls unexposed, sick; 9: Control unexposed, sick;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.27[1.11; 1.44]40,051202,72365%NALee (Controls unexposed, general pop), 2024 Brennan, 2023 Heuvelman, 2023 Suarez (Controls unexposed, discontinuers), 2022 Hagberg (Controls unexposed, sick), 2018 Brown, 2017 Liu, 2017 Rai (Controls unexposed, sick), 2017 Sujan (Controls unexposed, NOS), 2017 Boukhris (Controls unexposed, NOS), 2016 Malm (Controls unexposed, sick), 2016 El Marroun (Control unexposed, sick), 2014 12 case control studiescase control studies 1.69[1.11; 2.57]6,5633,88672%NAAmes (Controls unexposed, sick), 2021 Clements, 2015 Man, 2015 Harrington, 2014 Eriksson, 2012 Croen, 2011 6 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.60[1.26; 2.03]44,25629,88966%NALee (Controls unexposed, general pop), 2024 Brennan, 2023 Brown, 2017 Sujan (Controls unexposed, NOS), 2017 Boukhris (Controls unexposed, NOS), 2016 Clements, 2015 Man, 2015 Harrington, 2014 Eriksson, 2012 Croen, 2011 10 unexposed, sickunexposed, sick 1.18[1.09; 1.29]2,358176,7205%NAHeuvelman, 2023 Suarez (Controls unexposed, discontinuers), 2022 Ames (Controls unexposed, sick), 2021 Hagberg (Controls unexposed, sick), 2018 Liu, 2017 Rai (Controls unexposed, sick), 2017 Malm (Controls unexposed, sick), 2016 El Marroun (Control unexposed, sick), 2014 8 Tags Adjustment   - No  - No 1.89[0.78; 4.59]67619,08486%NABrennan, 2023 Hagberg (Controls unexposed, sick), 2018 Eriksson, 2012 3   - Yes  - Yes 1.29[1.14; 1.47]45,938187,52560%NALee (Controls unexposed, general pop), 2024 Heuvelman, 2023 Suarez (Controls unexposed, discontinuers), 2022 Ames (Controls unexposed, sick), 2021 Brown, 2017 Liu, 2017 Rai (Controls unexposed, sick), 2017 Sujan (Controls unexposed, NOS), 2017 Boukhris (Controls unexposed, NOS), 2016 Malm (Controls unexposed, sick), 2016 Clements, 2015 Man, 2015 El Marroun (Control unexposed, sick), 2014 Harrington, 2014 Croen, 2011 15 MatchedMatched 1.68[0.78; 3.63]2,16717468%NAClements, 2015 Harrington, 2014 Croen, 2011 3 Monotherapy   - no or not specified  - no or not specified 1.33[1.13; 1.57]44,241171,45369%NALee (Controls unexposed, general pop), 2024 Brennan, 2023 Heuvelman, 2023 Suarez (Controls unexposed, discontinuers), 2022 Ames (Controls unexposed, sick), 2021 Brown, 2017 Sujan (Controls unexposed, NOS), 2017 Malm (Controls unexposed, sick), 2016 Clements, 2015 Man, 2015 El Marroun (Control unexposed, sick), 2014 Harrington, 2014 Eriksson, 2012 Croen, 2011 14   - SSRI only  - SSRI only 1.29[1.07; 1.56]2,37335,15654%NAHagberg (Controls unexposed, sick), 2018 Liu, 2017 Rai (Controls unexposed, sick), 2017 Boukhris (Controls unexposed, NOS), 2016 4 Partial overlappingPartial overlapping 1.18[1.04; 1.35]48829,4550%NAHeuvelman, 2023 Hagberg (Controls unexposed, sick), 2018 2 Unexposed sick   - intermediate history of illness/tre ...  - intermediate history of illness/treatment (3-12 months before pregnancy) 1.11[0.93; 1.32]48845,18447%NAHeuvelman, 2023 Hagberg (Controls unexposed, sick), 2018 Malm (Controls unexposed, sick), 2016 3   - old history of illness/treatment (> ...  - old history of illness/treatment (> 12 months before pregnancy) or not specified 1.31[1.08; 1.58]84016,21131%NALiu, 2017 Rai (Controls unexposed, sick), 2017 2   - recent illness/treatment (during o ...  - recent illness/treatment (during or juste before pregnancy or treatment stopped in view of pregnancy) 1.17[1.01; 1.36]1,030115,3250%NASuarez (Controls unexposed, discontinuers), 2022 Ames (Controls unexposed, sick), 2021 El Marroun (Control unexposed, sick), 2014 3 All studiesAll studies 1.32[1.16; 1.50]46,614206,60966%NALee (Controls unexposed, general pop), 2024 Brennan, 2023 Heuvelman, 2023 Suarez (Controls unexposed, discontinuers), 2022 Ames (Controls unexposed, sick), 2021 Hagberg (Controls unexposed, sick), 2018 Brown, 2017 Liu, 2017 Rai (Controls unexposed, sick), 2017 Sujan (Controls unexposed, NOS), 2017 Boukhris (Controls unexposed, NOS), 2016 Malm (Controls unexposed, sick), 2016 Clements, 2015 Man, 2015 El Marroun (Control unexposed, sick), 2014 Harrington, 2014 Eriksson, 2012 Croen, 2011 180.210.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-1.81.80.5920.000Lee (Controls unexposed, general pop), 2024Brennan, 2023Heuvelman, 2023Suarez (Controls unexposed, discontinuers), 2022Ames (Controls unexposed, sick), 2021Hagberg (Controls unexposed, sick), 2018Brown, 2017Liu, 2017Rai (Controls unexposed, sick), 2017Sujan (Controls unexposed, NOS), 2017Boukhris (Controls unexposed, NOS), 2016Malm (Controls unexposed, sick), 2016Clements, 2015Man, 2015El Marroun (Control unexposed, sick), 2014Harrington, 2014Eriksson, 2012Croen, 2011

Asymetry test p-value = 0.5480 (by Egger's regression)

slope=0.2154 (0.1097); intercept=0.4922 (0.8021); t=0.6137; p=0.5480

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded 480, 7046, 6463, 11132, 7480, 7840, 7838, 7837, 10002, 17050, 17444

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.60[1.35; 1.88]64,661181,06581%NALee (Controls unexposed, general pop), 2024 Brennan, 2023 Suarez (Controls unexposed, general pop), 2022 Ames (Controls unexposed, disease free), 2021 Hagberg (Controls unexposed, disease free), 2018 Brown, 2017 Rai (Controls unexposed, disease free), 2017 Sujan (Controls unexposed, NOS), 2017 Boukhris (Controls unexposed, NOS), 2016 Malm (Controls unexposed, disease free), 2016 Clements, 2015 Man, 2015 El Marroun (Control unexposed, disease free), 2014 Harrington, 2014 Eriksson, 2012 Croen, 2011 16 unexposed, sick controlsunexposed, sick controls 1.18[1.09; 1.29]2,358176,7205%NAHeuvelman, 2023 Suarez (Controls unexposed, discontinuers), 2022 Ames (Controls unexposed, sick), 2021 Hagberg (Controls unexposed, sick), 2018 Liu, 2017 Rai (Controls unexposed, sick), 2017 Malm (Controls unexposed, sick), 2016 El Marroun (Control unexposed, sick), 2014 8 exposed to other treatment, sick controlsexposed to other treatment, sick controls 0.77[0.55; 1.07]53521,65527%NAHagberg (Controls exposed to TCA), 2018 Rai (Controls exposed to TCA), 2017 Boukhris (Controls exposed to TCA), 2016 3 siblingssiblings 0.83[0.61; 1.12]33711,5210%NALee (Controls unexposed, sibling), 2024 Sujan (Controls unexposed, sibling), 2017 20.510.01.0

Umbrella review (other published meta-analyses)

Published MAControlPeriodTE95% CIn exposedkI2 Andalib - SSRI (Autism spectrum disorder)Andalib - SSRI (Autism spectrum disorder) 1.83[1.59; 2.10]0%-Wwhatever (meta-analysis)Anyduring pregnancy (anytime or not specified)studies TTT7 Zhou - SSRI (Autism spectrum disorder _ Case ...Zhou - SSRI (Autism spectrum disorder _ Case control studies ) 2.08[1.54; 2.81]7.2%-Wwhatever (meta-analysis)T11st trimesterstudies TTT2 Halvorsen - SSRI (Autism spectrum disorder _ ...Halvorsen - SSRI (Autism spectrum disorder _ Case control studies) 1.60[1.26; 2.02]15%-Wwhatever (meta-analysis)Anyduring pregnancy (anytime or not specified)studies TTT5 Zhou - SSRI (Autism spectrum disorder _ Case ...Zhou - SSRI (Autism spectrum disorder _ Case control studies) 1.81[1.46; 2.23]0%-Wwhatever (meta-analysis)Anyduring pregnancy (anytime or not specified)studies TTT4 Zhou - SSRI (Autism spectrum disorder _ Case ...Zhou - SSRI (Autism spectrum disorder _ Case control studies) 1.94[1.41; 2.68]0%-Wwhatever (meta-analysis)T22nd trimesterstudies TTT3 Zhou - SSRI (Autism spectrum disorder _ Case ...Zhou - SSRI (Autism spectrum disorder _ Case control studies) 2.32[1.63; 3.30]0%-Wwhatever (meta-analysis)T33rd trimesterstudies TTT3 Man - SSRI (Autism spectrum disorder _ Case c ...Man - SSRI (Autism spectrum disorder _ Case control studies (ORa)) 1.81[1.47; 2.24]0%-Wwhatever (meta-analysis)Anyduring pregnancy (anytime or not specified)studies TTT4 Halvorsen - SSRI (Autism spectrum disorder _ ...Halvorsen - SSRI (Autism spectrum disorder _ Cohort studies) 1.27[1.10; 1.47]0%-Wwhatever (meta-analysis)Anyduring pregnancy (anytime or not specified)studies TTT4 Zhou - SSRI (Autism spectrum disorder _ Cohor ...Zhou - SSRI (Autism spectrum disorder _ Cohort studies) 1.22[0.83; 1.79]64.7%-Wwhatever (meta-analysis)Anyduring pregnancy (anytime or not specified)studies TTT3 Zhou - SSRI (Autism spectrum disorder _ Cohor ...Zhou - SSRI (Autism spectrum disorder _ Cohort studies) 1.04[0.81; 1.34]42.7%-Wwhatever (meta-analysis)T11st trimesterstudies TTT3 Zhou - SSRI (Autism spectrum disorder _ Cohor ...Zhou - SSRI (Autism spectrum disorder _ Cohort studies) 1.43[0.84; 2.42]71.6%-Wwhatever (meta-analysis)T2-T32nd and/or 3rd trimesterstudies TTT3 Kobayashi - SSRI (Autism spectrum disorder _ ...Kobayashi - SSRI (Autism spectrum disorder _ Study set A) 1.45[1.15; 1.82]31%-Wwhatever (meta-analysis)Anyduring pregnancy (anytime or not specified)studies TTT7 Kobayashi - SSRI (Autism spectrum disorder _ ...Kobayashi - SSRI (Autism spectrum disorder _ Study set A) 0.96[0.57; 1.63]35%-U,Sunexposed, sickAnyduring pregnancy (anytime or not specified)studies TTT3 Kobayashi - SSRI (Autism spectrum disorder _ ...Kobayashi - SSRI (Autism spectrum disorder _ Study set B) 1.55[1.28; 1.88]19%-Wwhatever (meta-analysis)Anyduring pregnancy (anytime or not specified)studies TTT7 Kobayashi - SSRI (Autism spectrum disorder _ ...Kobayashi - SSRI (Autism spectrum disorder _ Study set B) 1.22[0.72; 2.08]34%-U,Sunexposed, sickAnyduring pregnancy (anytime or not specified)studies TTT3 Kaplan - SSRI (Autism spectrum disorders)Kaplan - SSRI (Autism spectrum disorders) 1.61[1.16; 2.25]46%-Wwhatever (meta-analysis)Anyduring pregnancy (anytime or not specified)studies TTT4 Kaplan - SSRI (Autism spectrum disorder_Case ...Kaplan - SSRI (Autism spectrum disorder_Case control studies) 1.66[1.23; 2.23]37%-Wwhatever (meta-analysis)Anyduring pregnancy (anytime or not specified)studies TTT5 Kaplan - SSRI (Autism spectrum disorder_Case ...Kaplan - SSRI (Autism spectrum disorder_Case control studies) 1.90[1.28; 2.83]42%-Wwhatever (meta-analysis)T11st trimesterstudies TTT4 Kaplan - SSRI (Autism spectrum disorder_Case ...Kaplan - SSRI (Autism spectrum disorder_Case control studies) 1.73[1.15; 2.61]29%-Wwhatever (meta-analysis)T22nd trimesterstudies TTT4 Kaplan - SSRI (Autism spectrum disorder_Case ...Kaplan - SSRI (Autism spectrum disorder_Case control studies) 1.64[0.83; 3.24]68%-Wwhatever (meta-analysis)T33rd trimesterstudies TTT4 Brown - SSRI (Autism _ All adjusted studies _ ...Brown - SSRI (Autism _ All adjusted studies _ Case control) 1.70[1.10; 2.60]NA-Wwhatever (meta-analysis)T11st trimesterstudies TTT4 Brown - SSRI (Autism _ All adjusted studies _ ...Brown - SSRI (Autism _ All adjusted studies _ Case control) 1.40[1.00; 2.00]NA-Wwhatever (meta-analysis)Anyduring pregnancy (anytime or not specified)studies TTT4 Brown - SSRI (Autism _ All adjusted studies _ ...Brown - SSRI (Autism _ All adjusted studies _ Cohort) 1.50[0.90; 2.70]NA-Wwhatever (meta-analysis)Anyduring pregnancy (anytime or not specified)studies TTT2 Brown - SSRI (Autism _ All adjusted studies _ ...Brown - SSRI (Autism _ All adjusted studies _ Cohort) 1.40[1.00; 1.90]NA-Wwhatever (meta-analysis)T11st trimesterstudies TTT1 Vega - SSRI (Autism _ Hazard ratio)Vega - SSRI (Autism _ Hazard ratio) 1.61[1.45; 1.79]-U,GPunexposed (general population or NOS)T11st trimesterstudies TTT3 Vega - SSRI (Autism _ Hazard ratio)Vega - SSRI (Autism _ Hazard ratio) 1.40[0.78; 2.52]-U,Sunexposed, sickT11st trimesterstudies TTT1 Vega - SSRI (Autism _ Hazard ratio)Vega - SSRI (Autism _ Hazard ratio) 1.52[1.29; 1.80]-U,GPunexposed (general population or NOS)Anyduring pregnancy (anytime or not specified)studies TTT5 Vega - SSRI (Autism _ Hazard ratio)Vega - SSRI (Autism _ Hazard ratio) 1.16[0.88; 1.51]-U,Sunexposed, sickAnyduring pregnancy (anytime or not specified)studies TTT3 Vega - SSRI (Autism _ Hazard ratio _ Discorda ...Vega - SSRI (Autism _ Hazard ratio _ Discordant Sibling) 0.83[0.58; 1.18]-U,Sunexposed, sickAnyduring pregnancy (anytime or not specified)studies TTT2 Vega - SSRI (Autism _ Hazard ratio _ Discorda ...Vega - SSRI (Autism _ Hazard ratio _ Discordant Sibling) 0.81[0.58; 1.14]-U,Sunexposed, sickT11st trimesterstudies TTT1 Vega - SSRI (Autism _ Odd ratio)Vega - SSRI (Autism _ Odd ratio) 1.81[1.45; 2.26]-U,GPunexposed (general population or NOS)T11st trimesterstudies TTT5 Vega - SSRI (Autism _ Odd ratio)Vega - SSRI (Autism _ Odd ratio) 1.70[0.64; 4.55]-U,Sunexposed, sickT11st trimesterstudies TTT1 Vega - SSRI (Autism _ Odd ratio)Vega - SSRI (Autism _ Odd ratio) 1.52[1.16; 2.00]-U,GPunexposed (general population or NOS)Anyduring pregnancy (anytime or not specified)studies TTT8 Vega - SSRI (Autism _ Odd ratio)Vega - SSRI (Autism _ Odd ratio) 1.26[0.89; 1.79]-U,Sunexposed, sickAnyduring pregnancy (anytime or not specified)studies TTT4 Vega - SSRI (Autism _ Odd ratio _ Discordant ...Vega - SSRI (Autism _ Odd ratio _ Discordant Sibling) 0.76[0.50; 1.16]-U,Sunexposed, sickAnyduring pregnancy (anytime or not specified)studies TTT2 Vega - SSRI (Autism _ Odd ratio _ Discordant ...Vega - SSRI (Autism _ Odd ratio _ Discordant Sibling) 0.83[0.58; 1.19]-U,Sunexposed, sickT11st trimesterstudies TTT1 Brown - SSRI (Autism, maternal mental illness ...Brown - SSRI (Autism, maternal mental illness-restricted analyse _ Case control) 1.40[0.90; 2.20]NA-U,Sunexposed, sickAnyduring pregnancy (anytime or not specified)studies TTT3 Brown - SSRI (Autism, maternal mental illness ...Brown - SSRI (Autism, maternal mental illness-restricted analyse _ Case control) 1.80[1.10; 3.10]NA-U,Sunexposed, sickT11st trimesterstudies TTT3 Brown - SSRI (Autism, maternal mental illness ...Brown - SSRI (Autism, maternal mental illness-restricted analyse _ Cohort) 1.40[1.00; 1.90]NA-U,Sunexposed, sickT11st trimesterstudies TTT1 Brown - SSRI (Autism, maternal mental illness ...Brown - SSRI (Autism, maternal mental illness-restricted analyse _ Cohort) 1.50[0.90; 2.70]NA-U,Sunexposed, sickAnyduring pregnancy (anytime or not specified)studies TTT2 McDonagh - SSRI (Diagnosis of autism spectrum ...McDonagh - SSRI (Diagnosis of autism spectrum disorder controlling for maternal depression diagnosis) 1.82[1.14; 2.91]NA-NAnot specifiedAnyduring pregnancy (anytime or not specified)studies TTT2 metaPregmetaPreg 1.32[1.16; 1.50]66%206,609----Lee (Controls unexposed, general pop), 2024 Brennan, 2023 Heuvelman, 2023 Suarez (Controls unexposed, discontinuers), 2022 Ames (Controls unexposed, sick), 2021 Hagberg (Controls unexposed, sick), 2018 Brown, 2017 Liu, 2017 Rai (Controls unexposed, sick), 2017 Sujan (Controls unexposed, NOS), 2017 Boukhris (Controls unexposed, NOS), 2016 Malm (Controls unexposed, sick), 2016 Clements, 2015 Man, 2015 El Marroun (Control unexposed, sick), 2014 Harrington, 2014 Eriksson, 2012 Croen, 2011 180.510.01.0