Autism and SSRI Use During Pregnancy Sparks Controversy

In a study published in 2011, researchers Croen, Grether, Yoshida, Odouli, and Hendrick (2011) used data from Kaiser Permanente patients in California to examine the the link of exposure to selective serotonin reuptake inhibitors (SSRIs) and autism. Results suggest that prenatal exposure to SSRIs during the first trimester “modestly increased the risk of ASD” (Croen, Grether, Yoshida, Odouli, & Hendrick, 2011). However, the researchers suggested looking at the potential risk factors of mothers or fetuses with untreated mental health disorders.

The study by Croen and colleagues (2011) generated pandemonium in the world of autism, as did a recent publication by JAMA Pediatrics provoking another uproar about autism and SSRI use during pregnancy. Boukhris, Sheehy, Mottron, and Bérard (2015) used data from the Quebec Pregnancy Cohort and concluded that there is an increased prevalence of autism in offspring of mothers using SSRIs during gestation. Boukhris and colleagues (2015) cautioned that the use of antidepressants during pregnancy and the risk of developing autism remain controversial.

Contrastingly, Hviid, Melbye, Pasternak (2013) examined SSRIs and autism in Danish births, and exonerates antidepressants by looking at mothers or fetuses with untreated mental health disorders. The study looked at 626,875 births and isolated possible confounders of children developing autism. Similar to the Canadian and California results, the researchers found that the use of antidepressants during pregnancy increased the risk of autism in children. However, when the researchers looked at the presence of underlying depression in the mother, the increased risk of taking SSRIs during pregnancy and autism were extinguished. Moreover, the researchers concluded that there was not a significant association between SSRI intake during pregnancy and autism in children. It is important to note that the Danish study’s size increases their reliability; however, the results may not apply to all populations (Autism Speaks, 2013).

While the world of autism research matures in the right direction, we look forward to reading progressive studies while teasing out possible confounds one factor at a time. Dr. Paul Wang states that the SSRI results in the Danish study are reassuring and adds, “the decision to use any medication during pregnancy should be discussed by the mother and her physician. But depression can pose serious risks if it’s untreated. So it’s important to have safe treatment options (Autism Speaks, 2013).”

References

Autism Speaks. (2013, December 18). Reassuring news on autism and SSRI use during pregnancy. Retrieved from https://www.autismspeaks.org/science/science-news/reassuring-news-autism-and-ssri-use-during-pregnancy

Boukhris, T., Sheehy, O., Mottron, L., & Bérard, A. (2015). Antidepressant use during pregnancy and the risk of autism spectrum disorder in children. JAMA Pediatrics, 14, 1-8.

Croen, L.A., Grether, J. K., Yoshida, C. K., Odouli, R., & Hendrick, V. (2011). Antidepressant use during pregnancy and childhood autism spectrum disorders. Arch Gen Psychiatry, 68, 1104-1112.

Hviid, A., Melbye, M., & Pasternak, B. (2013). Use of selective serotonin reuptake inhibitors during pregnancy and risk of autism. The New England Journal of Medicine, 369, 2406-2415.