Association Between Serotonergic Antidepressant Use During Pregnancy and Autism Spectrum Disorder in Children

Abstract

In children born to mothers receiving public drug coverage in Ontario, Canada, in utero serotonergic antidepressant exposure compared with no exposure was not associated with autism spectrum disorder in the child. Although a causal relationship cannot be ruled out, the previously observed association may be explained by other factors.

Increased attention should be paid to perinatal mental health and to the need of dedicated services

“…The association found between psychiatric disorders in children and antidepressant exposure in utero could be attributable to the severity of the mother’s underlying disease, as the authors correctly pointed out in their study6: women who are treated are likely to have more severe and recurrent illness. Furthermore, Brown and colleagues found that use of antidepressants 90–365 days prior but not during pregnancy (recent users) was significantly associated with autism spectrum disorders (adjusted HR 1.85, 95% CI 1.37 to 2.51) 5. They explained that this evidence corroborates the hypothesis that the indication for medication may clarify the increased risks for autism spectrum disorder and not the use of antidepressant medication itself.…”

“…Brown et al reported quite convincing data showing that the use of antidepressants before and during pregnancy in the mothers is not causally related to autism in the offspring 5. The association found between psychiatric disorders in children and antidepressant exposure in utero could be attributable to the severity of the mother’s underlying disease, as the authors correctly pointed out in their study6: women who are treated are likely to have more severe and recurrent illness.…”

“…Although in the scientific literature SSRIs are generally reported to be quite safe during pregnancy,4 three recent studies raised concerns that these drugs may have a negative impact on fetal brain development with long-term consequences on offspring, especially autism. Focusing on exposure to SSRIs in utero and risk of autism, Brown and colleagues analysed data from nearly 36 000 births in Ontario, Canada, between 2002 and 2010 5. A second study investigated the association between in utero antidepressant exposure and overall psychiatric disorders in offspring, examining specific subcategories, including autism spectrum disorder 6.…”

“…In order to assess the association between serotonergic antidepressant exposure during pregnancy and child autism spectrum disorder, Brown et al designed a retrospective cohort study using health administrative data from singleton children born in Ontario, Canada, between April 2002 and March 2010 5. Serotonergic antidepressant exposure was defined as two or more consecutive prescriptions for an SSRI or selective norepinephrine reuptake inhibitor medication filled between conception and delivery, and child autism spectrum disorder was identified after the age of 2 years.…”

Pharmacobiological Treatments in Autism Spectrum Disorders

“…However, two very recent studies have concluded that there is no significant relationship between prenatal exposure to SSRIs and ASD risk and suggest that the previously observed association may be due to other factors [22,23].…”