Autism, ADHD risk not linked to prenatal exposure to antidepressants

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.

Although many cases are minor, an estimated 20,000 pregnant women each year are thought to take antidepressants - around one in 25 of all British pregnancies. Yet, the researchers only found an association, not a cause-and-effect between prenatal exposure of SSRI antidepressants and autism risk in boys.

"The findings from this review suggest that antidepressant treatment may be a "marker" of women who may have an elevated risk of giving birth to a child with ASD", Petersen said.

Notably, mothers who use antidepressants during pregnancy are more likely to have depression than mothers who do not use these medications.

Although estimates put rates of depression among pregnant women as high as 20 percent, questions remain about whether women should take antidepressants during pregnancy.

"If you just look at the population as a whole, children born to women who take antidepressants are more likely to be diagnosed with autism than children born to mothers who don't take them", says D'Onofrio.

The study itself was huge. They even looked at fathers' use of antidepressants to determine if genetic factors were more likely to contribute to autism risk.

"Antidepressant exposure is unlikely to increase risk for autism spectrum disorder in children", Vigod told MedPage Today. "The genetic reason that brought the mom to use the drug may say more about the risk of autism in the child". This suggests that the antidepressants weren't the major contributor to the autism, and that something else in the children's experience-like their genetics or the environment in which they were raised, which could include the effect of their mother's depression on their development-played a greater role than the drugs. The researchers followed offspring until 2013, using Kaplan-Meier estimates to show the probability of diagnoses for children born in later years. And stopping an antidepressant can have serious consequences with regards to peri- and postpartum depression risk. They might smoke, drink, eat unhealthy foods, or not get enough sleep.

Irene Petersen, a researcher at the University College London, who was not involved in the study, said it's tricky to study the exposure on antidepressants in pregnancy and the risk of ASDs, as the effects of drug treatment are often hard to be separated from other risk factors such as maternal illnesses.

The findings were consistent with other studies done recently on the link between ADHD and autism and medications. Follow-up studies are needed to confirm their results.

The study also found that the association was weaker when past maternal illness of the mother was controlled for.

"I think this is one of these situations where this gets a lot of attention in the media, but the results are actually pretty challenging to interpret", said Dr. Jeremy Veenstra-VanderWeele, of the Columbia University Department of Psychiatry in NY.

"Balancing the risks and benefits of using antidepressants during pregnancy is an extremely hard decision that every woman should make in consultation with her doctor", he said.

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".

"What this did was help us have a measure of the likelihood of either parent having depression and whether that likelihood is associated with the outcome, and of course we found that", D'Onofrio said.

Vanessa Coleman

Comments