Antidepressant Use in Pregnancy: Autism Risk?
Preliminary Research Suggests Possible Risk of Autism From Use of SSRIs During Pregnancy
Autism Diagnosis continued...
Twenty mothers of children with ASD (6.7%) and 50 mothers of children without ASD (3.35%) had at least one prescription for an antidepressant in the year prior to giving birth.
Seventy-five percent of those mothers of children with ASD took SSRIs, either alone or with other types of antidepressants. Prescribed SSRIs noted in the study included fluoxetine (Prozac), fluvoxamine (Luvox), paroxetine (Paxil), and sertraline (Zoloft).
When compared with women who did not take antidepressants during pregnancy, those who had been prescribed SSRIs were more than twice as likely to have a child diagnosed with ASD.
The association was not seen with other types of antidepressants, but this may be because so few women took non-SSRI drugs.
The study, which was funded in part by the CDC, is published online in the Archives of General Psychiatry.
Depression During Pregnancy
Between 14% and 23% of women experience depression symptoms during pregnancy, according to the American Congress of Obstetricians and Gynecologists (ACOG).
In a 2009 joint statement, ACOG and the American Psychiatric Association concluded that both antidepressant use and untreated depression pose potential risks for mother and baby.
University of Pittsburgh Medical Center assistant professor of psychiatry Dorothy Sit, MD, tells WebMD that women taking antidepressants should never stop taking them without talking to their doctors.
"This study is intriguing, but it does not establish a direct link between SSRI use and autism," she says. "We would need to study this in much greater detail to do this."
The Kaiser Permanente researchers conclude that even if the association is confirmed, SSRI exposure is not likely to be a major risk factor for autism and related disorders.
Tracy Flanagan, MD, who is director of women's health for Kaiser Permanente Northern California, says maternal depression itself may be an unrecognized risk factor for autism. In the study, the researchers found no link between a history of depression or other mental health disorder and ASD.
She adds that decisions about treatment must be made on a case-by-case basis by the patient, her ob-gyn, and her psychiatrist.
"A woman who has battled depression for many years and has a history of relapsing when she stops drug treatments is very different from a woman who had a single incidence of depression and is doing great," she says.