Antidepressants, especially selective serotonin reuptake inhibitors, may increase the risk of autism spectrum disorder in children when used during the final 2 trimesters of pregnancy, according to data published in JAMA Pediatrics.
The association between antidepressant use during pregnancy and autism has long been controversial, as antidepressants continue to be widely used to treat depression during pregnancy and autism prevalence continues to rise. However, there has not been a lot of research conducted to investigate the possible relationship between the two and the long-term neurodevelopmental effects of the drugs on children.
In the current study, Anick Bérard, PhD, of the University of Montreal, Canada, and colleagues examined the risk of autism among children who may have been exposed to antidepressants during gestation. The researchers analyzed data collected from 145 456 single infants and their mothers from the Québec Pregnancy/Children Cohort between January 1, 1998 to December 31, 2009.
CLINICAL CHART: Psychotropic Drug Indications
The study authors identified 4724 infants (3.2%) who were exposed to antidepressants during gestation; 88.9% were exposed during the 1st trimester and 53.6% were exposed during the 2nd and/or 3rd trimester. Overall, 1054 children were diagnosed with autism spectrum disorder; 31 (1.2%) were exposed to antidepressants during the 2nd and/or 3rd trimester and 40 (1%) were exposed during the 1st trimester. Boys with autism spectrum disorder outnumbered girls 4:1. Use of antidepressants during the 2nd and/or 3rd trimester was associated with an 87% increased risk of autism spectrum disorder. Increased risk was observed for those exposed to selective serotonin reuptake inhibitors (22 exposed infants; adjusted hazard ratio, 2.17; 95% CI, 1.20-3.93) and those exposed to more than one class of antidepressant during the 2nd and/or 3rd trimester. The risk remained significant after adjusting for maternal history of depression (29 exposed infants; adjusted hazard ratio, 1.75; 95% CI, 1.03-2.97).
The researchers concluded that further research needs to be done to better understand the risk of autism associated with antidepressant use, including drug type and dosing, during pregnancy.