Previous research has been on both sides of the fence when it comes to the antidepressant and autism debate. Over 80 per cent of the antidepressants examined in the study were SSRIs.
Dr. Andrew Adesman is chief of developmental and behavioral pediatrics for Cohen Children's Medical Center in New Hyde Park, N.Y. He said the two studies "should provide further reassurance for women to continue taking their antidepressants when pregnant, if that is what their doctor has recommended".
In fact, when you take away the controls for siblings and other familial factors, the risks for premature birth, low fetal development, ADHD, and autism, is about 2 percent higher. To make matters more confusing, other research has shown that the drugs are safe for the developing fetus.
The researchers found similar results when they looked at antidepressant exposure during specific trimesters.
Data from four studies did show 77 percent higher odds of ASDs among children born to women who used antidepressants before pregnancy, however.
In an effort to dismantle the lingering uncertainty between antidepressants and autism, D'Onofrio and his colleagues sought to analyze data on over 1.5 million children whose mothers took antidepressants during pregnancy.
The association was also not significant when exposed children were compared with unexposed siblings.
First, siblings who were born after their mothers used antidepressants while pregnant were compared to those born when their mother didn't use the drugs. It turned out that rates of autism weren't that much different among these brothers and sisters.
Maternal depression is considered a risk factor for developmental disorders, like autism and ADHD.
For example, a genetic overlap exists in people who have depression and people who have autism.
Veenstra-VanderWeele, who was not involved with the new analysis, told Reuters Health it's hard to account for several factors that may also explain the increased risk of ASDs. This stresses the importance of researchers taking into account other factors that may influence the disorder.
But pregnant women on antidepressant medications should not stop taking them, because the data that tie their use in pregnancy to ASDs are weak, said the study's senior author. The choice to take antidepressant medication during pregnancy can be hard. Fathers' use of antidepressants was also looked at to determine if genetic factors were more likely to cause autism. "That suggests that the link is not due to the actual exposure from the drugs during pregnancy, but due to other factors".
Several large studies have found that women who took antidepressants during pregnancy were more likely to have children with autism, yet the question of whether that link was due to the medication-or the other factors that contribute to depression-remained, D'Onofrio says.
The analysis included matching moms who took antidepressants against those who didn't based on a series of 500 different variables in their life and health, Vigod said. This is good news, since depression affects about one in 10 women of child bearing age, so prospective moms may not have to choose between going off of their medication or having a healthy baby. "Many of us have started to look at longer term child outcomes related to antidepressant exposure because mothers want to know about that in the decision-making process", says Vigod, of Women's College Hospital in Toronto. Associations of Maternal Antidepressant Use During the First Trimester of Pregnancy With Preterm Birth, Small for Gestational Age, Autism Spectrum Disorder, and Attention-Deficit/Hyperactivity Disorder in Offspring.