Do antidepressants during pregnancy increase autism risk?
The researchers analysed data from 37 studies comparing 6,48,626 pregnancies in which antidepressants were used with nearly 25 million pregnancies without antidepressant use
A comprehensive systematic review and meta-analysis published in The Lancet Psychiatry, which examined data from over 37 studies involving nearly 25 million pregnancies, has found no clear link between the use of most antidepressants during pregnancy and an increased risk of neurodevelopmental disorders like autism and ADHD in children; while initial analyses suggested associations, these disappeared when confounding factors such as parental mental health and genetic predispositions were accounted for, indicating that the medications themselves are likely not the cause, and Selective Serotonin Reuptake Inhibitors (SSRIs) were deemed safe, though potential risks were noted with amitriptyline or nortriptyline, which are often prescribed for severe depression, suggesting the severity of the maternal condition might be a more significant factor.
A comprehensive systematic review and meta-analysis published in The Lancet Psychiatry, which examined data from over 37 studies involving nearly 25 million pregnancies, has found no clear link between the use of most antidepressants during pregnancy and an increased risk of neurodevelopmental disorders like autism and ADHD in children; while initial analyses suggested associations, these disappeared when confounding factors such as parental mental health and genetic predispositions were accounted for, indicating that the medications themselves are likely not the cause, and Selective Serotonin Reuptake Inhibitors (SSRIs) were deemed safe, though potential risks were noted with amitriptyline or nortriptyline, which are often prescribed for severe depression, suggesting the severity of the maternal condition might be a more significant factor.
A comprehensive systematic review and meta-analysis published in The Lancet Psychiatry, which examined data from over 37 studies involving nearly 25 million pregnancies, has found no clear link between the use of most antidepressants during pregnancy and an increased risk of neurodevelopmental disorders like autism and ADHD in children; while initial analyses suggested associations, these disappeared when confounding factors such as parental mental health and genetic predispositions were accounted for, indicating that the medications themselves are likely not the cause, and Selective Serotonin Reuptake Inhibitors (SSRIs) were deemed safe, though potential risks were noted with amitriptyline or nortriptyline, which are often prescribed for severe depression, suggesting the severity of the maternal condition might be a more significant factor.
A systematic review and meta-analysis published in The Lancet Psychiatry found no clear link between the use of antidepressants during pregnancy and an increased risk of neurodevelopmental disorders, including autism and attention-deficit/hyperactivity disorder (ADHD), in children.
“While all medications carry risks, so too does stopping antidepressants during pregnancy due to an increased risk of relapse,” the senior researcher said. “Therefore, for women with moderate-severe depression, doctors and patients must carefully weigh the potential risks and benefits of continuing antidepressant treatment during pregnancy against the potential harms of untreated depression.”
The researchers analysed data from 37 studies comparing 6,48,626 pregnancies in which antidepressants were used with nearly 25 million pregnancies without antidepressant use.
At first glance, the analysis suggested that maternal antidepressant use during pregnancy was associated with a 35 per cent increased risk of ADHD and a 69 per cent increased risk of autism.
However, these risks disappeared when the researchers accounted for other risk factors for ADHD and autism, such as mental health disorders among the child’s parents.
“The increased risk was also seen in the children of fathers who took antidepressants and of mothers with antidepressant use before, but not during, pregnancy,” said the researcher. “Together, this suggests that it is not the antidepressants themselves causing an increased risk in autism and ADHD, but it is more likely to be due to other factors, including genetic predisposition to conditions such as ADHD, autism and mental health conditions.”
The use of all selective serotonin reuptake inhibitors (SSRIs) was found to be safe during pregnancy.
No difference in risk was observed between high and low doses of antidepressants taken during pregnancy.
An increased risk was found among mothers who took amitriptyline or nortriptyline. However, these medications are often prescribed in severe cases of treatment-resistant depression, suggesting that the severity of the mother’s depression itself may have influenced the associated risk.