Antidepressants During Pregnancy Not Tied to Autism

Antidepressants use among mothers during pregnancy and autism did not appear linked in large study

(RxWiki News) Women who take antidepressants may wonder about taking them while pregnant. One concern has involved increasing their children's risk of certain conditions like autism.

However, a recent study found no link between mothers' use of antidepressants during pregnancy and their children's risk of autism.

This research involved studying thousands of children over more than a decade in Denmark.

There was a tiny increased risk of autism among children of women who used antidepressants before pregnancy.

However, this risk may be related to other factors in the women. Past studies, taken together, have been inconclusive.

"Discuss medications during pregnancy with your OB/GYN."

This study, led by Anders Hviid, DrMedSci, of the Department of Epidemiology at Statens Serum Institut in Copenhagen, Denmark, looked at whether antidepressants taken during pregnancy were linked to a higher risk of autism.

The researchers followed a group of 626,875 Danish children from their births, between 1996 and 2005, through the year 2009.

The researchers gathered information on the use of selective serotonin reuptake inhibitors among the mothers during pregnancy.

Selective serotonin reuptake inhibitors, or SSRIs, are a common type of antidepressant. They include commonly used antidepressants such as escitalopram (Lexapro), fluoxetine (Prozac), citalopram (Celexa), fluvoxamine (Luvox), paroxetine (Paxil) and sertraline (Zoloft), among others.

The researchers also gathered information on how many of the children were diagnosed with autism spectrum disorders.

During the full follow-up period, these researchers identified 3,892 children who had been diagnosed with autism. That number translates to approximately 77 of every 100,000 children per year.

Within those cases were 52 children whose mothers had used SSRIs during pregnancy, at a rate of approximately 123 children per 100,000 a year.

Although the rates differed in raw numbers, the researchers made calculations that took into account various other differences in characteristics of the women.

These calculations determined there was not an increased risk of autism among the children whose mothers used SSRIs, compared to those who did not use them, that could not possibly be attributed to chance findings.

However, these researchers did find a slightly higher risk of autism among children of mothers who had used SSRIs before becoming pregnant. The risk was small, and it's not clear whether the link was actually related to antidepressants or to another factor that women taking the antidepressants had in common.

"If women with depression or other indications for SSRI use are more likely to have children with autism spectrum disorders, a false association between SSRI use and autism spectrum disorders will be present in an observational study," the researchers wrote.

These researchers concluded that there was not a link found in this study between autism and a child's exposure to SSRIs in the womb, but they recommended further study.

“Although these results provide some reassurance, the authors themselves note that their conclusions are far from definitive both because of relatively low SSRI use compared to that in the U.S. and because of a relatively low reported prevalence of autism," said Glen Elliott, MD, PhD, a clinical professor at the Stanford University Department of Psychiatry and Behavioral Sciences.

"Even so, data from such a large sample gives increased confidence that an association between SRRI use before and during pregnancy is unlikely," he said. "Given the value of continued treatment of major depression during pregnancy, this should be a relief for both caregivers and future mothers.”

This study was published December 19 in the New England Journal of Medicine. The research was funded by the Danish Health and Medicines Authority.

The authors reported no potential conflicts of interest other than receiving funding from the Danish Health and Medicines Authority.

Review Date: 
December 19, 2013