Background and Objective:
An inconsistent association between exposure to SSRIs and SNRIs and the risk for ASD and ADHD in the Offspring was observed in observational studies. Some suggest that the reported association might be due to unmeasured confounding. We aimed to study this association and to look for sources of bias by performing a systematic review and meta-analysis.
Methods:
Medline, Embase, and the Cochrane Library were searched up to June 2019 for studies reporting on ASD and ADHD in the Offspring following exposure during pregnancy. We followed the PRISMA 2009 guidelines for data selection and extraction. Outcomes were pooled using random-effects models and odds ratios (OR), and 95% confidence intervals (CI) were calculated for each outcome using the adjusted point estimate of each study.
Results:
Eighteen studies were included in the meta-analysis. We found an association between SSRIs/SNRIs prenatal use and the risk for ASD and ADHD (OR=1.42, 95% CI: 1.23–1.65, I2=58%; OR=1.26, 95% CI: 1.07-1.49, I2=48%, respectively). Similar findings were obtained in women who were exposed to SSRIs/SNRIs before pregnancy, representing statistically significant association with ASD (OR=1.39, 95% CI: 1.24-1.56, I2=33%) and ADHD (OR=1.63, 95% CI: 1.50-1.78, I2=0%) in the Offspring, although they were not exposed to those medications in utero.
Conclusions:
Although we found an association between exposure to SSRIs/SNRIs during pregnancy and the risk for ASD and ADHD, an association with those disorders was also present for exposure pre-pregnancy, suggesting that the association might be due to unmeasured confounding. We are aiming to further assess the role of potential unmeasured confounding in the estimation of the association and perform a network meta-analysis.
The chromatographic resolution of enantiomeric amino acids Is accomplished on reversed phase columns using aqueous mobile phases containing the chiral reagent L-aspartylcyclohexylamide-Cu(II) [AspcHex-Cu(II)]. This reagent has the additional advantage that the copper ions allow the detection of nonaromatic amino acids at 230 nm. The separation seems to be a result of hydrophobic Interactions between the cyclohexylamide moiety of the chiral additive and the side chain of the amino acids. The results indicate that the composition of the chiral reagent in the mobile phase is (AspcHex)2Cu(II) and that the amino acids must replace one of the AspcHex for the resolution to occur.
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