Taking antidepressants during pregnancy doesn't increase child's risk of autism, ADHD

Risk assessment The risk of autism associated with antidepressants if it exists

Two scientific studies published Tuesday suggested the risk of children developing autism after their mothers used antidepressants while pregnant may be lower than previously believed.

In addition to the use of these medications during early pregnancy, the study looked at concurrent antidepressant use in fathers, as well as mothers' use of antidepressants before but not during pregnancy.

She told the Business Standard: 'The findings from this review suggest that antidepressant treatment may be a "marker" of women who may have an elevated risk of giving birth to a child with ASD. Associations of Maternal Antidepressant Use During the First Trimester of Pregnancy With Preterm Birth, Small for Gestational Age, Autism Spectrum Disorder, and Attention-Deficit/Hyperactivity Disorder in Offspring. All of these uses were found to be associated with increased risk for autism, ADHD and poor fetal growth. One team focused on a set of Canadian children, while the other evaluated a group of Swedish children. One of the siblings was exposed to antidepressants while in the mother's womb, whereas the other had not been exposed to the drugs. "The risk of autism spectrum disorder in a child is quite low regardless of whether you use antidepressants or not".

The underlying disorder, not the antidepressants, could well be a contributing cause, the study said.

The researchers also compared siblings born with antidepressant exposure against brothers or sisters with no exposure in the womb. They controlled for genetics, antidepressant use, and even the mother's age during pregnancy, since that can also have a factor on an infant's health.

Although many cases are minor, an estimated 20,000 pregnant women each year are thought to take antidepressants - around one in 25 of all British pregnancies. Some studies appeared to show a connection, while others showed none.

"It could be due to genetic factors that influence depression in the mothers and problems in the children, it could be due to poor prenatal care", says D'Onofrio. He's a professor of developmental psychopathology at Indiana University Bloomington.

Still, while the study shows that there is no link to autism or ADHD, the risk for premature birth is still 1.3 percent higher than in women who take antidepressants. "It could be that a child born to a mom who took an antidepressant might have a higher risk simply because there's a genetic predisposition that has nothing to do with the drug".

"However, I would be very cautious about reaching a conclusion that antidepressants treatment in pregnancy itself is causing autism". They might smoke, drink, eat unhealthy foods, or not get enough sleep.

The findings are concerning given the increasing usage of the medications during pregnancy, experts say.

In the final study, published in JAMA Pediatrics, Dr. Florence Gressier from University of Paris-Sud, in France, agrees that better studies are needed on the topic.

Thomas Frazier, chief science officer of Autism Speaks, agreed. This could have disastrous consequences, including maternal suicide, the study said.

"I think this is one of these situations where this gets a lot of attention in the media, but the results are actually pretty challenging to interpret", said Dr. Jeremy Veenstra-VanderWeele, of the Columbia University Department of Psychiatry in NY.

D'Onofrio says the study raises other questions.

"Balancing the risks and benefits of using antidepressants during pregnancy is an extremely hard decision that every woman should make in consultation with her doctor", he said.

- In the study with Ontario data, no association was found between children with ASD and the use of SSRI antidepressants during pregnancy among mothers receiving public drug coverage.

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