Study points to link between antidepressant use in pregnancy and autism in children

July 19, 2017
Credit: CC0 Public Domain

Children exposed to antidepressants during pregnancy seem to be at a slightly higher risk of autism than children of mothers with psychiatric disorders who were not treated with antidepressants during pregnancy, finds a study published in The BMJ today.

However, the researchers stress that the absolute risk of autism was small, so these results should not be considered alarming.

Depression is common in women of childbearing age, and in Europe 3-8% of pregnant women are prescribed antidepressants during .

Several studies have reported associations between antidepressant use during pregnancy and autism in offspring. But it is not clear whether this is due to the underlying illness, antidepressant drugs, or other unmeasured factors.

Such factors (known as confounding) can introduce bias and affect the results of a study, making it difficult to draw firm conclusions about cause and effect.

In a bid to minimise the effects of confounding - and better understand the reasons behind this association - a research team led by Dheeraj Rai at the University of Bristol applied a range of analytical methods to a large Swedish population.

They analysed data from 254,610 individuals aged 4-17, including 5,378 with autism, living in Stockholm in 2001-11 who were born to mothers who did not take antidepressants and did not have any psychiatric disorder, mothers who took antidepressants during pregnancy, or mothers with who did not take antidepressants during pregnancy.

Of the 3,342 children exposed to antidepressants during pregnancy, 4.1% (136) had a diagnosis of autism compared with 2.9% (353) in 12,325 children not exposed to antidepressants whose mothers had a history of a psychiatric disorder.

There was no evidence of any increased risk of autism in children whose fathers were prescribed antidepressants during the mothers' pregnancy.

The results of the various analyses seemed to be consistent with each other, say the authors, suggesting that the association between antidepressant use in pregnancy and autism might not be fully explained by confounding.

They point to some study limitations, such as lack of detailed measures of severity of depression. However key strengths were the large sample size and the range of analyses carried out to minimise bias.

So what should families and doctors making decisions about antidepressants during pregnancy make of such results?

It is important to note that the absolute risk was small (over 95% of women in the study who took antidepressants during pregnancy did not have a child with autism), stress the authors.

They estimate that, even if the association between antidepressant use and autism is causal, only 2% of cases would be prevented if no women with psychiatric disorders used antidepressants during pregnancy.

They call for "a balanced discussion in relation to clinical decision making in the light of evolving but yet inconsistent evidence" and say "it is important to continue investigation of possible underlying biological mechanisms that could help us to better understand the aetiology of autism."

In a linked editorial, Diana Schendel at Aarhus University in Denmark says the findings of this study "should be viewed through the kaleidoscope of possible causes of autism" and calls for future studies to be better powered, and include measures of maternal disease severity, more reliable measures of antidepressant use, and, ideally genetic markers.

She points to the "reassuring study message" that more than 95% of women in the study who took did not have a child with .

Although such a small risk within a population might seem too high from an individual's perspective, "it must be carefully weighed against the substantial health consequences associated with untreated depression," she concludes.

Explore further: No statistically significant risk of ID in children from mothers using antidepressants

More information: BMJ (2017). www.bmj.com/content/358/bmj.j2811

BMJ (2017). www.bmj.com/content/358/bmj.j3388

Related Stories

No statistically significant risk of ID in children from mothers using antidepressants

July 12, 2017
A study published by JAMA Psychiatry reports no evidence of an association between intellectual disability in children and mothers who took antidepressant medication during pregnancy when other mitigating factors, such as ...

Article examines studies on antidepressants, autism spectrum disorders

April 17, 2017
A new article published by JAMA Pediatrics reviews and analyzes a small collection of studies on fetal exposure to antidepressants and autism spectrum disorders (ASDs).

Study: Antidepressant use in early pregnancy does not increase autism, ADHD risk in kids

April 18, 2017
A study led by Indiana University suggests that mothers' use of antidepressants during early pregnancy does not increase the risk of their children developing autism or attention deficit hyperactivity disorder, conditions ...

Study finds no increased risk of autism, ADHD with prenatal antidepressant exposure

January 5, 2016
- An analysis of medical records data from three Massachusetts health care systems finds no evidence that prenatal exposure to antidepressants increases the risk for autism and related disorders or for attention-deficit hyperactivity ...

Antidepressants during pregnancy associated with childhood language disorders

October 12, 2016
Mothers who purchased antidepressants at least twice during pregnancy had a 37-percent increased risk of speech and/or language disorders among their offspring compared to mothers with depression and other psychiatric disorders ...

Recommended for you

Social phobia linked to autism and schizophrenia

December 11, 2017
New Swinburne research shows that people who find social situations difficult tend to have similar brain responses to those with schizophrenia or autism.

Odors that carry social cues seem to affect volunteers on the autism spectrum differently

November 27, 2017
Autism typically involves the inability to read social cues. We most often associate this with visual difficulty in interpreting facial expression, but new research at the Weizmann Institute of Science suggests that the sense ...

Video game improves balance in youth with autism

November 21, 2017
Playing a video game that rewards participants for holding various "ninja" poses could help children and youth with autism spectrum disorder (ASD) improve their balance, according to a recent study in the Journal of Autism ...

Potential new autism drug shows promise in mice

November 14, 2017
Scientists have performed a successful test of a possible new drug in a mouse model of an autism disorder. The candidate drug, called NitroSynapsin, largely corrected electrical, behavioral and brain abnormalities in the ...

Relational factors in music therapy can contribute to positive outcome for children with autism

November 6, 2017
It might not surprise that good relationships create good outcomes, as meaningful relational experiences are crucial to all of us in our everyday life. However, the development of a relationship with a child with autism may ...

In autism, too many brain connections may be at root of condition

November 2, 2017
A defective gene linked to autism influences how neurons connect and communicate with each other in the brain, according to a study from Washington University School of Medicine in St. Louis. Rodents that lack the gene form ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.