Good news about antidepressants in early pregnancy

When comparing unrelated children and controlling for related risk factors, the researchers found a slightly higher risk for all four conditions: 1.4 times higher odds for premature birth, 1.1 times higher odds for low fetal growth and 1.6 times higher risk for autism and ADHD. Researchers looked at more than 500 patients with sore throats. There was a small increased risk of preterm birth.

"Regardless of whether associations between antidepressant use during pregnancy and autism spectrum disorder reflect drug effects or risks inherent to maternal mental health, efforts should focus on how best to promote optimal child health in ways that harness a child's inherent developmental plasticity", Oberlander said.

In another study, Brian M. D'Onofrio of Indiana University, Bloomington, and colleagues evaluated alternative hypotheses for associations between first-trimester antidepressant exposure and birth and neurodevelopmental problems.

The researchers, who examined the data from several angles, concluded that antidepressant use early in pregnancy did not increase the risk of children developing autism or attention deficit hyperactivity disorder (ADHD), and that it was more likely genetics or a child's environment that heightened risk for these disorders.

Writing in JAMA Pediatrics, the team of scientists said up to 15 per cent of women have depression during pregnancy. Autism rates were not all different among brothers and sisters, according to the researchers.

"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. It also incorporated data reporting the country's antidepressant prescriptions in adults, autism and ADHD diagnoses in children, genetic relationships between parents and children, parents' age and education levels, and other factors.

"Although a causal relationship can not be ruled out, the previously observed association may be explained by other factors", said the second study. However, researchers warn that there are still other risks.

The research, reported today in the Journal of the American Medical Association, found significant evidence for only a slight increase in risk for premature birth in the infants of mothers who used antidepressants during the first trimester of pregnancy.

He added that most analyses depend on "statistical matching to control for differences in factors such as age, race and socioeconomic status".

"Increased illness severity may reflect increased exposure to maternal stress, which may influence early brain development via fetal programming of the hypothalamic-pituitary axis or immune function", they wrote. About 2 percent of the kids exposed to antidepressants were diagnosed with autism. Follow-up studies are needed to confirm their results.

- In the study with Ontario data, no association was found between children with ASD and the use of SSRI antidepressants during pregnancy among mothers receiving public drug coverage. That means their results are hard to interpret.

Two studies now shed light on what's behind that link and give some reassuring news for parents.

Dr Patrick O'Brien, spokesperson for the Royal College of Obstetricians and Gynaecologists, previously said: 'Depression in pregnancy can be very serious for a woman and can also impact on the health of her baby, so we must consider the benefits of antidepressant medication in such cases.

However, they warn that women relying on the drugs to correct their moods should not stop taking them as the evidence to prove antidepressants cause autism is weak.

Vanessa Coleman

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