Studies question autism link to antidepressants in pregnancy

Research by Indiana University found no increase in developmental disorders among fetuses exposed to antidepressants during early pregnancy

The study found no significant difference in risk for ADHD and autism in the siblings whose mothers used antidepressant medications one pregnancy but no the other pregnancy. The authors surmised that autism disorders in children may be connected to the mom's mental health condition rather than the drugs. The studies are published online April 18 in JAMA. Past research has questioned the safety of expectant moms taking antidepressants (SN: 6/5/10, p. 22). They also took into consideration the antidepressant prescription among the adults in the nation, along with autism and ADHD diagnosis in children.

Many women trying to get pregnant rejoice when they see the blue plus sign on the pregnancy test. "All treatment options should be explored".

"How do you treat depression?" Some women may benefit from psychotherapy alone.

Pregnant women diagnosed with depression may be able to receive psychotherapy instead of medication, but that's a discussion that needs to take place between a woman and her doctor, he said.

The findings are concerning given the increasing usage of the medications during pregnancy, experts say. "Could the negative outcomes be due to the depression itself, or stress or genetic factors?"

Vigod and her team reviewed nearly 36,000 Canadian children, just over 2,800 of whom were exposed to antidepressants in the womb.

In the first study, which is thought to be the largest and most comprehensive on the topic, researchers at Indiana University, in collaboration with researchers in Sweden, observed more than 1.5 million Swedish babies born between 1996 and 2012 to mothers who, in some cases, took antidepressants in the first trimester.

A majority of the antidepressants examined in the study were selective serotonin re-uptake inhibitors, more commonly known as SSRIs, which are the most common type of antidepressants.

'However, I would be very cautious about reaching a conclusion that antidepressants treatment in pregnancy itself is causing autism. She studied more than 35,000 births and also compared rates of autism among brothers and sisters whose mothers used antidepressants during some pregnancies but not others. Another new paper in JAMA Pediatrics similarly found that studies on the subject aren't consistent in how they account for such possible alternative contributors to autism. But some studies have shown that being exposed to antidepressants in utero can contribute to an increase in developmental conditions, including attention deficit hyperactivity disorder and autism.

Data from four studies did show 77 percent higher odds of ASDs among children born to women who used antidepressants before pregnancy, however.

Women who take anti-depressants in early pregnancy are not more likely to have children with autism or ADHD. "But that association goes completely away when you compare siblings".

Vigod and colleagues looked at mothers who qualified for public drug coverage in Ontario, Canada, from 2002 to 2010.

The increased risk for premature birth was found after controlling for other factors that affect health, such as a mother's age, and in siblings whose mothers used antidepressants during one pregnancy but not during another pregnancy. This suggests that the antidepressants weren't the major contributor to the autism, and that something else in the children's experience-like their genetics or the environment in which they were raised, which could include the effect of their mother's depression on their development-played a greater role than the drugs. "We can't ignore the fact that there are shared genetic mechanisms that might relate autism and depression".

"Based on our meta-analyses, there is a significant association between ASDs and prenatal maternal use of antidepressants".

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