Antidepressants in pregnancy linked to autism

2 minute read


  Pregnant women taking antidepressants have a “very significant” increased risk of having a child with autism, a large analysis suggests. Women taking antidepressants in the second and third trimester had an 87% higher chance of the child having autism, and it was more than double for those who took SSRIs, even after adjusting for […]


 

Pregnant women taking antidepressants have a “very significant” increased risk of having a child with autism, a large analysis suggests.

Women taking antidepressants in the second and third trimester had an 87% higher chance of the child having autism, and it was more than double for those who took SSRIs, even after adjusting for potential sociodemographic, physical and psychiatric confounders.

Even taking the mother’s history of depression into account, children were at a 77% increased risk of depression compared to those who were not exposed to antidepressants in-utero.

“We defined exposure to antidepressants as the mother having had one or more prescription for antidepressants filled during the second or third trimester of the pregnancy. This period was chosen as the infant’s critical brain development occurs during this time,” said Professor Anick Bérard, from the faculty of pharmacy, University of Montreal.

“Amongst all the children in the study, we then identified which children had been diagnosed with a form of autism by looking at hospital records indicating diagnosed childhood autism, atypical autism, Asperger’s syndrome, or a pervasive developmental disorder. Finally, we looked for a statistical association between the two groups, and found a very significant one: an 87% increased risk,” Professor Bérard said.

However, the register-based population cohort study of almost 150,000 Quebec children put the prevalence of autism at 0.7%, which is lower than recent estimates of 1%.

Boys with autism outnumbered girls at a ratio of 4:1.

Anti-depressants could cause autism due to their impact on serotonin, which is involved in many pre- and postnatal development processes, the authors said.

“[This includes] cell division, the migration of neuros, cell differentiation and synaptogenesis – the creation of links between brain cells,” Professor Bérard said.

“Some classes of anti-depressants work by inhibiting serotonin (SSRIs and some other antidepressant classes), which will have a negative impact on the ability of the brain to fully develop and adapt in-utero.”

Nevertheless, previous research has suggested SSRI use reduces the risk of late preterm birth and very preterm birth in mothers with psychiatric disorders but not taking psychotropics medications, an accompanying editorial noted.

JAMA Pediatr 2015; online 14 Dec

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