Prenatal Antidepressant Exposure and Autism: Three Studies Offer Some Reassurance — Physician’s First Watch
Prenatal Antidepressant Exposure and Autism: Three Studies Offer Some Reassurance
By Amy Orciari Herman
Three new studies suggest that antidepressant use during pregnancy doesn't lead to autism in offspring. However, maternal mental health could be a factor.
First, a JAMA Pediatrics meta-analysis of six case-control studies found that antidepressant use during pregnancy was associated with increased autism risk in offspring. However, maternal use of antidepressants before conception appeared to be more consistently associated with autism, leading researchers to conclude that maternal psychiatric illness before pregnancy — not antidepressant use during pregnancy — "could have a major role" in autism risk.
Next, in JAMA, an analysis of Canadian health records of nearly 36,000 singleton births, suggested increased risk for autism in children exposed in utero to selective serotonin or serotonin-norepinephrine reuptake inhibitors. However, the association was no longer significant after adjustment for 500 covariates or in sibling analyses.
Finally, an analysis of 1.6 million children in Sweden found that, after adjustment for confounders, first-trimester antidepressant exposure was not associated with autism or attention-deficit/hyperactivity disorder.
Dr. Robert Barbieri of NEJM Journal Watch Women's Health said, "The lack of a direct causal link between maternal antidepressant use and [autism] should be reassuring to parents and clinicians." JAMA editorialists write, "Disentangling the effects of maternal mood disorders on the fetus vs. shared genetic predisposition to mental and neurodevelopmental disorders is the next step."