This systematic review assesses the association between prenatal antidepressant exposure and risk of ADHD in children. Electronic databases were searched up to 25 July 2017. Observational studies examining this association were included in the review and meta-analysis was conducted where appropriate. Eight relevant studies were identified. The seven studies included in the meta-analysis comprised a total of 2,886,502 children. The pooled estimates comparing prenatal exposure to non-exposure showed an adjusted rate ratio (aRR) of 1.39 (95%CI 1.21–1.61). Similarly, an increased risk was found comparing previous antidepressant users and non-users: aRR = 1.56 (95%CI 1.25–1.95). The relationship between maternal psychiatric conditions and ADHD in children yielded an aRR of 1.90 (95%CI 1.47–2.45). Three studies conducted sibling-matched analyses with aRR of 0.94 (95%CI 0.75–1.16). These data suggest that the observed association between prenatal use of antidepressants and risk of ADHD in offspring can be partially explained by confounding by indication because the results from sibling-matched analyses do not support an increased risk of ADHD in discordant exposed siblings.

这项系统的评估评估了产前抗抑郁药暴露与儿童多动症风险之间的关联。截至2017年7月25日，对电子数据库进行了搜索。评价中包括检查该关联的观察性研究，并在适当时进行了荟萃分析。确定了八项相关研究。荟萃分析中包括的七项研究共计2,886,502名儿童。汇总的估计值比较了产前与未接触的暴露，调整后的比率（aRR）为1.39（95％CI 1.21-1.61）。同样，与以前使用抗抑郁药的人和未使用抗抑郁药的人相比，发现患病风险增加：aRR = 1.56（95％CI 1.25–1.95）。儿童的母亲精神状况与多动症之间的关系产生1.90的aRR（95％CI 1.47–2.45）。三项研究进行了同胞匹配分析，其aRR为0.94（95％CI 0.75–1.16）。这些数据表明，观察到的产前使用抗抑郁药与后代多动症风险之间的相关关系可以通过指示混淆来部分解释，因为同级匹配分析的结果并不支持不协调的暴露同胞增加ADHD的风险。