妊娠中のセロトニン抗うつ剤の使用と子供の自閉症スペクトル障害との関連

Hilary K Brown¹, Joel G Ray², Andrew S Wilton³

¹Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada2Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada3Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.

JAMA

|April 19, 2017

まとめ

この研究では,セロトナージック抗うつ薬と自閉症スペクトル障害の産前暴露との間に有意な関連性が見つかりませんでした. 過去の観察は,直接的な因果関係ではなく,混同要因によって説明できます.

科学分野:

神経科学
発達に関する小児科
薬学流行病学

背景:

以前の研究では,妊娠中の母親の抗うつ剤使用と,子供の自閉症スペクトル障害 (ASD) のリスクの増加との潜在的な関連が示唆されました.
しかし,これらの関連は混同要因によって影響を受け,さらなる調査が必要だったかもしれない.

研究の目的:

子宮内でのセロトナージック抗うつ薬と,子どもにおける自閉症スペクトル障害の診断との関連を調査する.
先進的な統計的方法を使って混乱を招く可能性のある要因に対処する.

主な方法:

カナダのオンタリオ州 (2002年−2010年) の健康管理データを用いた後見コホート研究.
セロトニン再吸収阻害剤 (SSRI) やセロトニン・ノルアピネフリン再吸収阻害剤 (SNRIs) の母親の暴露は,処方箋記録によって定義された.
子供は2歳までASDの診断を観察し,治療重度の逆確率と兄弟の比較を用いて分析を調整した.

主要な成果:

この研究には35,906人のシングルトン出産者が含まれており,その7. 9%が妊娠中にセロトニン抗うつ剤に曝された.
初期分析ではASDの発生率が高かったが,高次元の傾向スコアを用いて混同因子を調整したところ,この関連性は有意ではなかった.
曝露されていない兄弟と比べると,非有意な関連性も示された.

結論:

子宮内でのセロトナージック抗うつ薬への曝露は,オンタリオ州で公的薬物保険が適用されている母親から生まれた子供の自閉症スペクトル障害のリスク増加と関連していません.
以前に観察された関連は,直接的な因果関係ではなく,測定されていない混同要因に起因する可能性があります.

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