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Antidepressants in Pregnancy Tied to Autism

Risk of autism by age 7 nearly doubled, study finds

Using antidepressants during pregnancy greatly increases the risk of autism, according to a study from the University of Montreal. Professor Anick Bérard, an expert on pharmaceutical safety during pregnancy, came to this conclusion after reviewing data on 145,456 pregnancies. The findings were published in JAMA Pediatrics.

“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,” Bérard said.

In addition to information about the mother’s use of antidepressants and the child’s eventual diagnosis of autism, the study data included details that allowed Bérard and her colleagues to identify the specific effects of antidepressant drugs. For example, maternal age and depression are known to be associated with the development of autism, as are certain socio-economic factors, such as being exposed to poverty, and the team was able to take all of these into consideration.

The new findings are important, the authors say, because 6% to 10% of pregnant women are currently being treated with antidepressants. In the study, 1,054 children (0.72%) were diagnosed with autism at an average age of 4.5 years.

The prevalence of autism among children has increased from 4 in 10,000 children in 1966 to 100 in 10,000 today, according to the authors. While that increase may be attributed to better detection methods and widening criteria for diagnosis, the researchers believe that environmental factors also play a part.

“It is biologically plausible that antidepressants are causing autism if used at the time of brain development in the womb, as serotonin is involved in numerous pre- and postnatal developmental processes, including cell division, the migration of neuros, cell differentiation, and synaptogenesis –– the creation of links between brain cells,” Bérard explained. “Some classes of antidepressants work by inhibiting serotonin, which will have a negative impact on the ability of the brain to fully develop and adapt in utero."

The World Health Organization predicts that depression will be the second leading cause of death by 2020, which leads the researchers to believe that antidepressants will likely to remain widely prescribed, including during pregnancy. “Our work contributes to a better understanding of the long-term neurodevelopmental effects of antidepressants on children when they are used during gestation. Uncovering the outcomes of these drugs is a public health priority, given their widespread use,” Bérard said.

Sources: Medical Xpress; December 14, 2015; and JAMA Pediatrics; December 14, 2015.

 

 

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