Antidepressants in pregnancy increase autism risk in children

Probability of autism disease significantly increased by antidepressants during pregnancy
Taking medicines during pregnancy is often associated with significant risks to unborn children. A recent study has shown that the use of antidepressants in pregnancy leads to an increased risk of autism in children. The research team led by Professor Anick Bérard of the University of Montreal concludes that taking antidepressants during the second or third trimester of pregnancy doubles the risk of autism. In particular, when mothers take so-called selective serotonin reuptake inhibitors (SSRIs), the children are, according to the researchers, a dramatically increased risk of autism.

Although the causes of autism disorders have not been conclusively clarified to date, clear correlations have been found in various environmental factors and genetic predispositions. With the increase in prescribing antidepressants to pregnant women in the US, the researchers in their current study have now looked into whether antidepressants may have an impact on the risk of autism. Their results were published in the journal "JAMA Pediatrics".

The use of antidepressants in pregnancy leads to an increased risk of autism in children. (Image: dubova / fotolia.com)

Nearly 150,000 pregnancies evaluated
The researchers led by Prof. Bérard investigated the effect of antidepressants on the risk of autism in children based on the data from the "Québec Pregnancy / Children Cohort" study on just under 150,000 pregnancies. In addition to information on the use of antidepressants, it also collected a wealth of other data that may affect the risk of autism, such as genetic predisposition, maternal age, and socioeconomic factors. Even taking into account these influencing factors, according to the researchers, there was a significant correlation between the risk of autism and the use of antidepressants during the second and third trimesters of pregnancy. The focus was on investigations during this period, as the child's brain development during this time is particularly susceptible to external influences, explains Prof. Bérard. Until the age of seven years, the children's health was further monitored and the occurrence of autistic disorders recorded.

Autism risk doubles
According to their own statements, the researchers determined a clear statistical correlation between the use of antidepressants during pregnancy and the diagnosed autism disorders in children. The use of antidepressants during the second or third trimester of pregnancy has almost doubled the risk that the child will have autism by the age of seven, Bérard and colleagues write. The findings are particularly relevant as six to ten percent of pregnant women in the US are treated for depression with antidepressants. Out of the children in the study, 1,054 developed an autistic disorder (0.72% of study participants), with those on average 4.5 years old at the time of diagnosis. Almost one-third of children with autism had mothers taking antidepressants during pregnancy.

Increase in autism disorders
In general, the prevalence of autism in children has increased from four to 100 out of every 10,000 children since 1996, according to researchers. This increase was partly due to better detection or clearer criteria for diagnosis, but the experts also say that certain environmental factors related to the diseases have changed. The increased prescription of antidepressants in pregnant women is obviously one of these factors. It seems plausible that SSRIs in particular cause a drastic increase in the risk of autism "because serotonin is involved in numerous pre- and postnatal developmental processes, including the creation of connections between the brain cells," said Prof. Bérard.

Antidepressants despite risk sense?
Despite the proven link between the use of antidepressants in pregnancy and the risk of autism in children, the prescribing may be useful in the opinion of the researchers, as depressions can pose serious risks to the life of the mother and the unborn child. Thus, antidepressants are expected to be prescribed in the future during pregnancy. But a better understanding of the long-term effects on children's development is urgently needed, emphasize Prof. Bérard and colleagues. (Fp)