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Association between antidepressant use during pregnancy and autism spectrum disorder in children: a retrospective
Madoka Yamamoto-Sasaki1, Satomi Yoshida1, Masato Takeuchi1
11Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Yoshidakonoe-cho Sakyo-ku, Kyoto, 606-8501 Japan.
Insights
Antidepressant use during pregnancy was not linked to autism spectrum disorder (ASD) in children in Japan. This study found no significant association after adjusting for maternal depression, offering new evidence from Asian populations.
Area of Science:
- Perinatal mental health research
- Neurodevelopmental disorder epidemiology
- Pharmacovigilance in pregnancy
Background:
- Previous studies in Western countries suggested a potential link between prenatal antidepressant exposure and autism spectrum disorders (ASDs).
- Existing research remains inconclusive, necessitating further investigation across diverse populations.
- This study addresses the gap by examining antidepressant use and ASD risk in a Japanese cohort.
Purpose of the Study:
- To investigate the association between maternal antidepressant use during pregnancy and the risk of autism spectrum disorder (ASD) in offspring.
- To provide evidence from an Asian population, complementing existing data from Western countries.
- To clarify the relationship, accounting for potential confounding factors like maternal depression.
Main Methods:
- Retrospective cohort study utilizing linked mother-child claims data from Japan (2005-2014).
- Inclusion criteria required at least 24 months of follow-up data for children post-birth.
- Logistic regression analysis was employed to assess the association, adjusting for maternal depression.
Main Results:
- Initial crude analysis indicated a higher ASD prevalence with antidepressant use (OR, 2.32).
- However, after adjusting for maternal depression, the association became non-significant (OR, 0.76).
- The study included 26,925 mother-child pairs meeting the criteria.
Conclusions:
- No significant association was found between antidepressant use during pregnancy and autism spectrum disorder (ASD) in Japanese children after adjusting for confounders.
- This suggests that antidepressant use during pregnancy itself may not increase ASD risk.
- This study provides the first evidence from an Asian population on this topic.
Background:
Studies using data from Western countries have raised concerns that treating pregnant women with antidepressants may increase the risk of autism spectrum disorders (ASDs) in their offspring. However, to date, the studies are inconclusive. We therefore examined the association between antidepressant use and ASD using claims data collected in Japan.
Methods:
This retrospective cohort study was based on claims data from mothers and their children from January 2005 to July 2014, obtained from the Japan Medical Data Center. The information from mothers and children was linked using the family identification code. Information on antidepressant prescriptions during pregnancy was extracted from the database. To collect information on ASD, children for whom data were available 24 months or more after birth were followed up from birth through July 2014 or up until their withdrawal from the database. To ensure appropriate diagnosis of ASD, mother-child pairs where the children's data did not cover the 24 months after birth or pairs where children had a diagnosis of ASD within only 23 months after birth were excluded from the study cohort. We used logistic regression analyses to evaluate the association between antidepressant use during pregnancy and the children's ASD diagnosis. All statistical analyses were performed using IBM SPSS (Statistical Package for the Social Sciences) Statistics ver. 21.0.
Results:
Of the 53,864 eligible mother-child pairs, 26,925 met the study criteria. Crude analysis showed that the ASD prevalence in children was significantly higher with any antidepressant use than with non-use (odds ratio [OR], 2.32; 95% confidence interval [CI], 1.08, 4.95). However, when the analysis was adjusted for the confounding effect of maternal depression during pregnancy, statistical significance was lost (OR, 0.76; CI, 0.27, 2.18).
Conclusions:
After adjustment for confounders, we found no significant association between antidepressant use during pregnancy and ASD in children in Japan. This result provides additional evidence to support the idea that antidepressant use during pregnancy itself is not associated with an increase in ASD in children. In addition, this represents the first evidence based on Asian data.
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