Here we go again. If the risk of birth defects wasn’t enough, one study states that pregnant women taking antidepressants are putting their child at risk for developing autism or autism spectrum disorders. The study published in the Archives of General Psychiatry suggests there is an association between the use of antidepressants during pregnancy and Autism Spectrum Disorders in children.
The antidepressants studied are called Selective Serotonin Reuptake Inhibitors (SSRIs). SSRIs are a class of compounds typically used as antidepressants in the treatment of depression, anxiety disorders, and some personality disorders. They include products such as Zoloft, Wellbutrin, Lexapro, and Prozac. This just adds to the the potential risk of birth defects already associated with these drugs.
The study in Archives of General Psychiatry explores the association between autism and maternal SSRI use during pregnancy. In this population-based case-control study, the investigators evaluated the medical records of 298 children with autism spectrum disorder (82.9% male) and 1507 healthy controls from the Childhood Autism Perinatal Study. All were born between January 1995 and June 1999 at a Kaiser Permanente facility in Northern California. Medical records were used to identify children with autism, Asperger syndrome, and pervasive developmental disorder.
Study Results: Possible Link Between SSRI Use and Autism
This study found children had a greater risk of developing autism spectrum disorders if their moms took SSRIs during pregnancy.
The risk for autism spectrum disorder was significantly increased for children with exposure to any SSRI during the year before delivery (adjusted odds ratio [AOR]=2.2); the risk was highest when the exposure occurred during the first trimester (AOR=3.8). Among those children with mothers who had a history of mental health treatment but did not take SSRIs during pregnancy, there was no increase in risk for ASD.
This study indicates a possible association between SSRI exposure and childhood ASD, which can be explained as either a two- to threefold increase in risk or as an increase from 1% to 2% or 3%. Although the study was carefully done, its findings need to be replicated. Prescription use was not confirmed, diagnoses were from medical records and not psychiatric interviews, and factors such as tobacco, alcohol, and drug use were not controlled for.
In an interview for Medscape, Dr. Lisa Croen lead author of the article and director of the Autism Research Program at Kaiser Permanente Northern California (KPNC) stated, “It is possible that the association we found between maternal SSRI use and autism is in fact explained by the underlying condition for which the woman took the medication.”
Because children with ASD are more likely to have a family history psychiatric illness, this study attempted to distinguish between the effects of medication exposure versus the effects of the underlying disease that led to treatment. While previous history of mood and anxiety disorders is factored into the analyses, acute illness during pregnancy is not factored in. Multiple studies suggest that untreated depression may lead to physiologic changes which negatively affect fetal development and birth outcomes; thus, this omission greatly diminishes the value of the article to assess the impact of SSRIs in pregnancy on the risk of autism in children.
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