Antidepressant Use During Pregnancy Tied to Autism Risk

A new study has uncovered an association between prenatal exposure to antidepressant medication, autism spectrum disorder (ASD), and developmental delays (DD) in boys.

Researchers at Johns Hopkins University (JHU; Baltimore, MD, USA) and the University of California Davis (UCD, USA) evaluated 966 mother-child pairs—492 ASD, 154 DD, and 320 with typical development (TD)—from the Childhood Autism Risks from Genetics and the Environment (CHARGE) study to examine associations between prenatal use of selective serotonin reuptake inhibitors (SSRIs) and the odds of ASDs and DDs. Standardized measures were employed to confirm developmental status, and interviews with biological mothers ascertained prenatal SSRI use, maternal mental health history, and sociodemographic information.

The results showed that the prevalence of prenatal SSRI exposure was lowest in TD children (3.4%) but did not differ significantly from ASD (5.9%) or DD (5.2%) children. Among boys, prenatal SSRI exposure was nearly three times as likely in children with ASD relative to TD, with the strongest association tied to first-trimester exposure. Exposure was also elevated among boys with DD, and was strongest in the third trimester. The findings were similar among mothers with an anxiety or mood disorder history. The study was published online on April 14, 2014, in Pediatrics.

“This study provides further evidence that in some children, prenatal exposure to SSRIs may influence their risk for developing an autism spectrum disorder,” said senior author Irva Hertz-Picciotto, PhD, MPH, chief of the division of environmental and occupational health at UCD. “This research also highlights the challenge for women and their physicians to balance the risks versus the benefits of taking these medications, given that a mother's underlying mental-health conditions also may pose a risk, both to herself and her child.”

The prevalence of ADS continues to rise, and according to the US Centers for Disease Control and Prevention (CDC; Atlanta, GA, USA), an estimated 1 in 68 children in the United States is identified with ADS, and it is almost five times more common among boys than girls. One of the hypothesized reasons is that since serotonin is critical to early brain development, exposure during pregnancy to anything that influences serotonin levels (such as an SSRI) can have potential effect on birth and developmental outcomes.

Related Links:
Johns Hopkins University
University of California Davis
US Centers for Disease Control and Prevention