Prenatal Antidepressant Exposure Does Not Up Autism, ADHD Risk in Kids

Multiple studies have assessed the impact of mom’s antidepressant use during early pregnancy and autism risk among her children, with conflicting results.

A new, large scale study now suggests that a mother’s use of antidepressants during early pregnancy doesn’t appear to elevate the risk of her children developing autism or attention deficit hyperactivity disorder (ADHD).

These developmental conditions were previously associated with fetal exposure to antidepressants.

The study out of Indiana University (IU) came up with fresh evidence after looking at all live births in Sweden between 1996 and 2012, over 1.5 million babies, as well as analyzing data on prenatal exposure to antidepressants.

In their study, the researchers found that antidepressants may not pose a risk of autism as previously believed. According to them, factors like genes linked to mental illness or environmental reasons may be more strongly connected to autism than exposure to anti-depression drugs.

Co-author Brian D’Onofrio, who is director of clinical training in the department of psychological and brain sciences at Indiana University, however, insisted use of antidepressants during early pregnancy may pose other health risks.

For instance, the researchers found mothers’ use of antidepressants during the first trimester of pregnancy was linked to a slight increase in risk for premature birth in their offspring.

More precisely, while no link was found to autism or ADHD, the risk for premature birth was 1.3 percent higher higher for offspring exposed to antidepressants compared to unexposed offspring.

“To our knowledge, this is one of the strongest studies to show that exposure to antidepressants during early pregnancy is not associated with autism, ADHD or poor fetal growth when taking into account the factors that lead to medication use in the first place,” said D’Onofrio.

“Balancing the risks and benefits of using antidepressants during pregnancy is an extremely difficult decision that every woman should make in consultation with her doctor,” he said. “However, this study suggests use of these medications while pregnant may be safer than previously thought.”

The majority of the antidepressants examined in the study (82 percent) were selective serotonin reuptake inhibitors (SSRIs). The most common type of SSRIs include fluoxetine (Prozac), sertraline (Zoloft) and citalopram (Celexa).

In addition to the use of antidepressants during early pregnancy, D’Onofrio’s team also looked at fathers’ use of antidepressant, as well as mothers’ use of antidepressants before conception but not during pregnancy.

These uses of antidepressant medications found to be associated with elevated risk for autism, ADHD and poor fetal growth, providing evidence that genetics or environmental factors have an impact on these outcomes.

D’Onofrio said follow-up studies are needed to confirm the current findings, which were published April 18 in the Journal of the American Medical Association (JAMA).