Studies cast doubt on ASD, antidepressant link
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Three studies cast doubt on association between autism spectrum disorders and antidepressants.

This artilce also appeared in the 2017, volume 2 issue of ARI's Autism Research Review International newsletter.

Three new studies suggest that there is little or no association between maternal antidepressant use during pregnancy and autism spectrum disorders (ASD) in children.

In the first study, Ayesha Sujan and colleagues reviewed data from more than 1.5 million children born in Sweden between 1996 and 2012. In their initial analysis, the researchers found that first-trimester exposure to antidepressants was significantly associated with ASD, attention-deficit/hyperactivity disorder, preterm birth, and small size for gestational age.

However, the researchers used three additional approaches to test their findings. “First,” senior author Brian D’Onofrio says, “we compared siblings where mothers had used antidepressants in some pregnancies but not others. Second, we compared children of women who used antidepressants before pregnancy but not during or after pregnancy to children of women who used antidepressants during the first trimester of pregnancy. And third, we assessed the risk of the outcomes among children of fathers who took antidepressants during the first trimester of pregnancy.” When the researchers added these factors to their analyses, they found that the use of antidepressants during the first trimester of pregnancy was associated only with a slightly higher risk for preterm birth.,

D’Onofrio says, “These findings provide further support that family factors, rather than the specific exposure during pregnancy, explain associations between maternal antidepressant use during pregnancy and autism spectrum disorder and ADHD.”

In the second study, Hilary Brown and colleagues analyzed data from nearly 36,000 births in Ontario, Canada between 2002 and 2010. While the researchers found a strong association between maternal antidepressant use during pregnancy and ASD in offspring, this association disappeared when the researchers controlled for a large number of potential confounders and when they compared exposed and unexposed siblings.

In the third study, Antonia Mezzacappa and colleagues performed a meta-analysis of ten studies investigating a possible association between maternal antidepressant use during pregnancy and ASD in children. The researchers report, “There is a significant association between increased ASD risk and maternal use of antidepressants during pregnancy; however, it appears to be more consistent during the preconception period than during each trimester. Maternal psychiatric disorders in treatment before pregnancy rather than antenatal exposure to antidepressants could have a major role in the risk for ASDs.”

“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,” Ayesha C. Sujan, Martin E. Rickert, A. Sara Öberg, Patrick D. Quinn, Sonia Hernández-Díaz, Catarina Almqvist, Paul Lichtenstein, Henrik Larsson, and Brian M. D’Onofrio, Journal of the American Medical Association, Vol. 317, No. 15, April 18, 2017, 1553-1562. Address: Brian D’Onofrio, Department of Psychological and Brain Sciences, Indiana University, Bloomington, Indiana 47405.

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“Association between serotonergic antidepressant use during pregnancy and autism spectrum disorder in children,” Hilary K. Brown, Joel G. Ray, Andrew S. Wilton, Yona Lunsky, Tara Gomes, and Simone N. Vigod, Journal of the American Medical Association, Vol. 317, No. 15, April 18, 2017, 15441552. Address: Simone Vigod, Women’s College Research Institute, Women’s College Hospital, Toronto, Ontario, Canada.

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“Risk for autism spectrum disorders according to period of prenatal antidepressant exposure: a systematic review and meta-analysis,” Antonia Mezzacappa, Pierre-Alexandre Lasica, Francesco Gianfagna, Odile Cazas, Patrick Hardy, Bruno Falissard, Anne-Laure Sutter-Dallay, and Florence Gressier, Journal of the American Medical Association, April 17, 2017 (online). Address: Antonia Mezzacappa, Department of Psychiatry, Assistance Publique-Hôpitaux de Paris, Bicêtre University Hospital, Le Kremlin Bicêtre, France. —and—

Additional comments from Dr. D’Onofrio are available at https://news.iu.edu/doc/donofrioantidepressant-faq.pdf.