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December 23, 2015
Antidepressants Used During Pregnancy Linked to Higher Autism Rates
Montreal—Expectant mothers who take antidepressants might be putting their child at substantially higher risk of autism spectrum disorder (ASD), especially if the drugs are used in the second and third trimesters, according to a review of 145,456 pregnancies. The research, which followed the cases from conception to the children reaching age 10, was published recently in JAMA Pediatrics. “The variety of causes of autism remains unclear, but studies have shown that both genetics and environment can play a role,” explained lead researcher Anick Bérard, PhD, of the University of Montreal. “Our study has established that taking antidepressants during the second or third trimester of pregnancy almost doubles the risk that the child will be diagnosed with autism by age 7, especially if the mother takes selective serotonin reuptake inhibitors, often known by its acronym SSRIs.” For the study, the researchers used data from the Quebec Pregnancy Cohort, looking at a variety of factors, including information about the mother’s use of antidepressants and the child's eventual diagnosis of autism. “We defined exposure to antidepressants as the mother having had one or more prescriptions 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,” Bérard said in a University of Montreal press release. “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.” During 904035.50 person-years of follow-up, 1054 children (0.7%) were diagnosed with autism spectrum disorder, with boys outnumbering girls four-to-one. Use of selective serotonin reuptake inhibitors during the second and/or third trimester was significantly associated with an increased risk of ASD, with an adjusted hazard ratio of 2.17. Background information in the article notes that antidepressants are widely used by pregnant women. In the United States, the prevalence of antidepressant drug (AD) use during pregnancy increased from 5.7% in 1999 to 13.3% in 2003. An accompanying editorial recommends against any knee-jerk response to the study. “Of course, even one potentially preventable case is noteworthy. But this finding must also be viewed in the context of other risks,” writes Bryan H. King, MD, MBA, of Seattle Children’s Hospital. “It makes no more sense to suggest that ADs should always be avoided than to say that they should never be stopped,” King points out. “In the ongoing search for environmental contribution to the risk of ASD, in utero exposures are increasing as the focus. It is unlikely that there will be a straight line from such exposures that leads unwaveringly to ASD, and future studies should expand the neurodevelopment outcomes examined.” |
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