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Antidepressant use during pregnancy linked to autism in offspring

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According to the Centers for Disease Control and Prevention, 11% of Americans aged 12 years and older take antidepressant medications. In addition, more women than men take them. Some of these women are of child-bearing age. A new study has reported that the offspring of women who take antidepressants during pregnancy are more likely to suffer from autism spectrum disorder or developmental delay. The study was published online on April 14 in the journal Pediatrics by researchers at Johns Hopkins University, the University of Massachusetts Medical School, and the University of California, Davis, Davis, California

The researchers conducted a study on the use of commonly-prescribed antidepressants, known as selective serotonin reuptake inhibitors (SSRIs) during pregnancy and the risk of autism spectrum disorders and other developmental delays in their offspring. SSRIs include Prozac, Paxil, Lexapro, and Zoloft.

The study group comprised 966 mother-child pairs (492 with autism spectrum disorder, 154 with developmental delays, and 320 with normal development. The subjects were enrolled in the Childhood Autism Risks from Genetics and the Environment (CHARGE) Study. Standardized testing procedures were used to determine the developmental status of the children. Interviews with the mothers determined prenatal SSRI use, maternal mental health history, and sociodemographic data.

The investigators found that, overall, the prevalence of prenatal SSRI exposure was lowest in children with normal development (3.4%); however, it did not differ significantly from that of children with autism spectrum disorder (5.9%) or developmental delay (5.2%). When the results were limited to males, however, prenatal SSRI exposure was almost three times as likely in children with autism spectrum disorder, compared to normal children. In addition, the strongest association was found with first-trimester (first three months of pregnancy) exposure. Exposure was also found to be higher among boys with developmental delay and was strongest in the third trimester. The findings did not differ among mothers with an anxiety or mood disorder history.

The authors concluded that, in boys, prenatal exposure to SSRIs may increase the risk of autism spectrum disorder or developmental delay. They noted that findings on other studies of SSRIs and autism spectrum disorder continue to be inconsistent. They noted that this may due to inaccurate reporting of SSRI use from the mothers or other confounding factors. They recommended that larger studies should be conducted to clarify the situation. They point out that maternal depression itself carries risks for the fetus, the benefits of prenatal SSRI use should be judiciously weighed against potential harms.

Approximately 1 in 88 children suffer from an autism spectrum disorder, according to estimates from the Centers for Disease Control and Prevention (CDC'). It is more common in boys and occurs among all racial, ethnic, and socioeconomic groups.