Association of Autism with Antidepressant Use During Pregnancy
Two new studies suggest that maternal use of antidepressants during pregnancy is not associated with autism. The first study, conducted in Canada, was a retrospective cohort study of 35,906 singleton births from 2002 to 2010, with the children followed until March 31, 2014, looking at the effects of serotonergic antidepressants. The absolute rate of autism was higher in the antidepressant group, but after sophisticated statistical analysis, the association was not significant (HR, 1.61; 95% CI, 0.997-2.59). The association also was not significant when exposed children were compared with unexposed siblings (incidence of autism spectrum disorder was 3.40 per 1,000 person-years vs. 2.05 per 1,000 person-years, respectively; adjusted HR, 1.60; 95% CI, 0.69-3.74). The authors suggested that although “a causal relationship cannot be ruled out, the previously observed association may be explained by other factors” (JAMA 2017;317:1544-1552).
In the second study, conducted in Sweden, first trimester maternal antidepressant use was evaluated with regard to offspring birth problems or neurodevelopmental problems. The records of nearly 1.6 million offspring were evaluated. First-trimester antidepressant exposure was associated significantly with preterm birth (odds ratio, 1.3 in a sibling comparison analysis) but not with risk of being born small for gestational age or later autism spectrum disorder or attention-deficit/hyperactivity disorder (JAMA 2017;317:1553-1562).
An accompanying editorial reminds us that regardless of antidepressant treatment, children of mothers with depression remain at increased risk of developmental issues. Moving away from a focus on antidepressant medications alone will “disentangle” the effects of maternal mood disorders on the fetus vs. shared genetic predispositions to mental and neurodevelopmental disorders (JAMA 2017;317:1533-1534).
Two new studies suggest that maternal use of antidepressants during pregnancy is not associated with autism.
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