Association between SSRIs in pregnancy and childhood autism spectrum disorders

January 01, 0001

Association between SSRIs in pregnancy and childhood autism spectrum disorders

The prevalence of autism spectrum disorders (ASDs) has increased over recent years. Use of antidepressant medications during pregnancy also shows a secular increase in recent decades, prompting concerns that prenatal exposure may contribute to increased risk of ASD. These US authors systematically evaluated whether prenatal exposure to antidepressant medications is associated with increased risk of ASD in as population-based case-control study. Medical records were used to ascertain case children and control children and to derive prospectively recorded information on mothers' use of antidepressant medications, mental health history of mothers, and demographic and medical covariates. The subjects were 298 case children with ASD (and their mothers) and 1507 randomly selected control children (and their mothers).

They found: "Prenatal exposure to antidepressant medications was reported for 20 case children (6.7%) and 50 control children (3.3%). In adjusted logistic regression models, we found a 2-fold increased risk of ASD associated with treatment with selective serotonin reuptake inhibitors by the mother during the year before delivery (adjusted odds ratio, 2.2), with the strongest effect associated with treatment during the first trimester (adjusted odds ratio, 3.8). No increase in risk was found for mothers with a history of mental health treatment in the absence of prenatal exposure to selective serotonin reuptake inhibitors."

The authors Concluded: "Although the number of children exposed prenatally to selective serotonin reuptake inhibitors in this population was low, results suggest that exposure, especially during the first trimester, may modestly increase the risk of ASD. The potential risk associated with exposure must be balanced with the risk to the mother or fetus of untreated mental health disorders. Further studies are needed to replicate and extend these findings."

The association is fairly strong. More research is needed.

For the full abstract, click here.

Arch Gen Psychiatry 68(11):1104-1112, November 2011 © 2011 to the American Medical Association
Antidepressant Use During Pregnancy and Childhood Autism Spectrum Disorders. Lisa A. Croen, Judith K. Grether, Cathleen K. Yoshida, Roxana Odouli, Victoria Hendrick. Correspondence to Dr. Croen: lisa.a.croen@kp.org

Category: N. Neurological, W. Pregnancy, Family Planning. Keywords: autism spectrum disorders, children, pregnancy, serotonin reuptake inhibitors, SSRIs, case control study, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 22 November 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.