Autism risk following antidepressant medication during pregnancy

Area of Science:

• Perinatal Psychiatry
• Neurodevelopmental Disorders
• Pharmacovigilance

Background:

• Conflicting evidence exists regarding maternal antidepressant use during pregnancy and offspring autism spectrum disorder (ASD) risk.
• Previous studies have yielded inconsistent results, necessitating further investigation.

Purpose of the Study:

• To investigate the association between prenatal exposure to antidepressant medication and the risk of ASD in offspring.
• To clarify the relationship between maternal antidepressant use and ASD development.

Main Methods:

• A large population-based cohort study included 179,007 children born between 2006-2007, followed until 2014.
• Cox regression analysis estimated relative risks (RRs) of ASD, adjusting for confounders in the full sample and a subsample of mothers with psychiatric diagnoses.
• Specific antidepressant drugs were analyzed for their association with offspring ASD risk.

Main Results:

• The adjusted RR of ASD in children exposed to any antidepressant during pregnancy was 1.23 (95% CI 0.96-1.57).
• Associations were not significant in women with a history of depression or anxiety (RR: 1.07; 95% CI 0.80-1.43).
• Initial analyses suggested increased ASD risk with citalopram/escitalopram and clomipramine, but confidence intervals were wide.

Conclusions:

• Prenatal antidepressant exposure does not appear to have a causal association with increased ASD risk in offspring.
• The observed association is likely attributable to shared genetic or environmental factors related to maternal psychiatric susceptibility.
• These findings suggest that pregnant women should not forgo necessary antidepressant treatment due to concerns about ASD risk in their children.