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New study assesses risk of ASD in children after antidepressant use during pregnancy

December 14, 2015

A new study in JAMA Pediatrics examines health records to assess the possible risk of autism spectrum disorder (ASD) in children whose mother’s took antidepressants during pregnancy. The findings indicate an increased risk of ASD diagnoses in children who were exposed to the type of antidepressants known as selective serotonin reuptake inhibitors (SSRIs) during the second and third trimesters of pregnancy.

Researchers conducted a study of more than 145,000 births over a nine year span. They found 1054 children (0.7 percent) were diagnosed with ASD – which represents an 87 percent increased risk than children not exposed to antidepressants.

Epidemiologist and Autism Speaks Director of Public Health Michael Rosanoff said those findings require important context. “Risk does not equal cause. Eighty-seven percent risk is actually very modest. If the average child has a 1 percent risk, then these children had an 1.87 chance. It may be a risk factor, but according to this study it increases the risk only modestly.”

Rosanoff also urged women with depression to seek medical guidance if they have any doubts. “Women who have depression and are pregnant or considering becoming pregnant should discuss their concerns with their doctors before making any changes to their current medical treatment. There is no evidence to suggest a women should change her medication at this time, but it’s important to understand the risks and benefits of any medication, especially during pregnancy.”

Previous studies have actually supported antidepressant use during pregnancy, and this study appears to exclude some of those variables.

Autism Speaks Director of Medical Research Dr. Paul Wang said, “This study suggests that there is some kind of connection between depression, prenatal development, and autism. But it doesn't prove that antidepressants cause autism. Antidepressants appear to decrease the chance of prematurity, which is itself a risk factor for autism. The researchers of this new paper did not account for all babies who were born prematurely, so they did not capture this possible protective effect.” 

Dr. Wang also pointed to previous research that indicates depression and autism may share genetic ties. “Some of the genes related to depression also raise the risk of ASD.” 

These new findings add to existing research, which looks for links and possible risk factors associated with ASD, particularly during pregnancy. Rosanoff offered this perspective, “This study does fit in with the larger body of autism research suggesting that the prenatal period is a critical window for a child's neurodevelopment, which appears to be particularly sensitive to possible environmental factors during the second and third trimesters.”