Study Casts Doubt on Link Between Prenatal Antidepressant Exposure, Autism Risk Previous studies that have suggested an increased risk of autism among children of women who took antidepressants during pregnancy may actually reflect the known increased risk for autism spectrum disorder associated with severe maternal depression. In a study published online Aug. 26 in Molecular Psychiatry, investigators from Massachusetts General Hospital ... Research in Brief
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Research in Brief  |   November 01, 2014
Study Casts Doubt on Link Between Prenatal Antidepressant Exposure, Autism Risk
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Special Populations / Autism Spectrum / Research in Brief
Research in Brief   |   November 01, 2014
Study Casts Doubt on Link Between Prenatal Antidepressant Exposure, Autism Risk
The ASHA Leader, November 2014, Vol. 19, online only. doi:10.1044/leader.RIB4.19112014.np
The ASHA Leader, November 2014, Vol. 19, online only. doi:10.1044/leader.RIB4.19112014.np
Previous studies that have suggested an increased risk of autism among children of women who took antidepressants during pregnancy may actually reflect the known increased risk for autism spectrum disorder associated with severe maternal depression.
In a study published online Aug. 26 in Molecular Psychiatry, investigators from Massachusetts General Hospital report that—although ASD was more common in the children of mothers prescribed antidepressants during pregnancy than in those with no prenatal exposure—when the severity of the mother’s depression was accounted for, that increased risk was no longer statistically significant. An increased risk for attention-deficit hyperactivity disorder, however, persisted even after controlling for factors relating to a mother’s mental health.
“We know that untreated depression can pose serious health risks to both a mother and child, so it’s important that women being treated with antidepressants who become pregnant, or who are thinking about becoming pregnant, know that these medications will not increase their child’s risk of autism,” says senior author Roy Perlis, a physician in the MGH Department of Psychiatry.
The authors caution that although genetic factors are known to play a substantial role in ASD, exactly how that risk may be exacerbated by environmental factors is not well understood. Animal studies and investigations based on health records suggest an increased risk associated with prenatal antidepressant exposure, but others found no such association. And because discontinuing antidepressant treatment significantly increases the risk of relapse—including an increased risk of postpartum depression—scientists designed the current study to clarify whether any increased autism risk could be attributed to the medication.
The research team analyzed electronic health record data for children born at MGH, Brigham and Women’s Hospital, and Newton Wellesley Hospital for whom a diagnostic code for pervasive developmental disorder was entered at least once between 1997 and 2010. They matched data for almost 1,400 such children with those of more than 4,000 controls with no autism diagnoses.
Then researchers paired the children’s information with that of their mothers, noting any factors—including prescriptions for antidepressants and other psychotropic drugs—related to the diagnosis and treatment of major depression or other mental illness. They performed a similar analysis for almost 2,250 children with an attention deficit hyperactivity disorder diagnosis and more than 5,600 matched controls with no ADHD diagnoses.
Although prenatal exposure to antidepressants increased the risk for either condition, adjusting for factors indicating more severe maternal depression reduced the strength of that association to an insignificant level for autism. Antidepressants with stronger action in the serotonin pathway—which has been suspected of contributing to a possible autism risk—did not increase the incidence of the disorder. In addition, the children of mothers who took a serotonin-targeting nonantidepressant drug for severe morning sickness had no increased autism incidence. Prescriptions for antipsychotic drugs sometimes used to treat severe, treatment-resistant depression, as well as psychotic disorders, did appear to increase the risk for autism. For ADHD, however, the increased risk associated with prenatal antidepressant exposure remained significant, although reduced, even after adjustment for the severity of maternal depression.
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November 2014
Volume 19, Issue 11