Autism and SSRI use in pregnancy

Reported in the Journal Pediatrics, SSRI (anti depressants) in pregancy associated with higher rate of autism.

There is a possibility that is serotonin uptake inhibitors could mess up the chemistry of the developing brain–the Odds ratio is more than 2 so it’s not one of those studies you can dismiss because of small associations.
TAKE-HOME MESSAGE
In 966 mother–child pairs, including children with autism spectrum disorders (ASDs), developmental delays (DDs), and typical development (TD), boys with ASD were three times more likely than children with TD to have been prenatally exposed to selective serotonin reuptake inhibitors (SSRIs), and children with DDs were also more likely than children with TD to have been exposed.
While further studies are required to further support the findings of this research, prenatal exposure to SSRIs may increase the risk of ASDs and DDs. Risks associated with maternal depression and mood disorders, as well as the risks and benefits of SSRI use during pregnancy, must be carefully evaluated.
ABSTRACT
OBJECTIVE
To examine associations between prenatal use of selective serotonin reuptake inhibitors (SSRIs) and the odds of autism spectrum disorders (ASDs) and other developmental delays (DDs).
METHODS
A total of 966 mother-child pairs were evaluated (492 ASD, 154 DD, 320 typical development [TD]) from the Childhood Autism Risks from Genetics and the Environment (CHARGE) Study, a population-based case-control study. Standardized measures confirmed developmental status. Interviews with biological mothers ascertained prenatal SSRI use, maternal mental health history, and sociodemographic information.
RESULTS
Overall, prevalence of prenatal SSRI exposure was lowest in TD children (3.4%) but did not differ significantly from ASD (5.9%) or DD (5.2%) children. Among boys, prenatal SSRI exposure was nearly 3 times as likely in children with ASD relative to TD (adjusted odds ratio [OR]: 2.91; 95% confidence interval [CI]: 1.07-7.93); the strongest association occurred with first-trimester exposure (OR: 3.22; 95% CI: 1.17-8.84). Exposure was also elevated among boys with DD (OR: 3.39; 95% CI: 0.98-11.75) and was strongest in the third trimester (OR: 4.98; 95% CI: 1.20-20.62). Findings were similar among mothers with an anxiety or mood disorder history.
CONCLUSIONS
In boys, prenatal exposure to SSRIs may increase susceptibility to ASD or DD. Findings from published studies on SSRIs and ASD continues to be inconsistent. Potential recall bias and residual confounding by indication are concerns. Larger samples are needed to replicate DD results. Because maternal depression itself carries risks for the fetus, the benefits of prenatal SSRI use should be carefully weighed against potential harms.
Pediatrics
Prenatal SSRI Use and Offspring With Autism Spectrum Disorder or Developmental Delay
Pediatrics 2014 Apr 14;[EPub Ahead of Print], RA Harrington, LC Lee, RM Crum, AW Zimmerman, I Hertz-Picciotto

2 thoughts on “Autism and SSRI use in pregnancy”

  1. Until there are operational definitions of the various forms of ‘autism’ (recall it is not a single condition, but a group of ‘related’ conditions), there will be little progress in the clinical identification, assessment, treatment, prevention, or cure for any of them.
    Until then ‘autism’ will resemble more than anything else the legendary description of an elephant by a group of blind men.

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