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"More and more women are given antidepressant medication while they are pregnant.
[However} our survey cannot demonstrate that the risk of having a child with autism is increased by taking antidepressant medication during pregnancy."
Jakob Christensen, PhD, Aarhus University Hospital
Antidepressant medication does not increase the risk of autism
New research cannot establish a close connection between the use of antidepressant medication - the so-called SSRIs - during the course of pregnancy and the risk of having a child with autism.
"More and more women are given antidepressant medication while they are pregnant. And an increasing number of children are diagnosed with autism. This has given rise to concern over a possible connection. In contrast to other, smaller studies, our survey cannot demonstrate that the risk of having a child with autism is increased by taking antidepressant medication during pregnancy."
Jakob Christensen, PhD, researcher, Aarhus University, staff specialist, Aarhus University Hospital
Previous research has shown that the risk of having a child with autism is up to five times greater for pregnant women who take antidepressant medication.
Largest study of correlation
In a large register study, Jakob Christensen and his colleagues from Aarhus University and Aarhus University Hospital have followed more than 600,000 Danish children born in the period between 1996-2006. The survey is the largest so far undertaken of the correlation between antidepressant medication during pregnancy and autism.
The initial results of the Danish study showed that there was almost a two percent risk of having a child with autism for pregnant women who take antidepressant medication during their pregnancy.
For women who do not take antidepressant medication during pregnancy the risk was 1.5 percent.
But the researchers also analysed siblings and parents' psychiatric diagnoses. And when these are taken into account the risk is shown to be minimal.
"We know from previous studies that there is an increased risk for autism, among other things, if the parents have a mental diagnosis such as depression. But we cannot demonstrate that the risk is further increased if the mother has received prescription antidepressant medication during the pregnancy," says Jakob Christensen, adding:
"By analysing data for siblings we can see that the risk of having a child with autism is largely the same regardless of whether the mother takes antidepressant medication or not during the pregnancy."
The researchers cannot thereby demonstrate that the medication is to blame for autism in children.
Many women have antidepressant drugs prescribed by their general practitioner. Researcher in general practice Mogens Vestergaard believes that the survey also contains important knowledge for general practitioners:
"Most of the people who receive SSRIs get them through their general practitioner. This was also the case for 80 percent of the women who received antidepressant medication in the study. Of course the results of the survey provide important knowledge for the general practitioners. They are the ones who meet pregnant women who are nervous about the consequences of taking antidepressant medication during their pregnancy," says Professor Mogens Vestergaard from Aarhus University.
The researchers stress that there may be other risks associated with taking antidepressant medication during pregnancy. People should therefore contact their medical doctor in any case if they are under medication and considering becoming pregnant, so that they can receive the best possible advice.
The study has just been published in the internationally recognized journal Clinical Epidemiology.
Background: Both the use of antidepressant medication during pregnancy and the prevalence of autism spectrum disorder have increased during recent years. A causal link has recently been suggested, but the association may be confounded by the underlying indication for antidepressant use. We investigated the association between maternal use of antidepressant medication in pregnancy and autism, controlling for potential confounding factors.
Methods: We identified all children born alive in Denmark 1996–2006 (n=668,468) and their parents in the Danish Civil Registration System. We obtained information on the mother's prescriptions filled during pregnancy from the Danish National Prescription Registry, and on diagnoses of autism spectrum disorders in the children and diagnoses of psychiatric disorders in the parents from the Danish Psychiatric Central Register. In a cohort analysis, we estimated hazard ratios of autism spectrum disorders in children exposed to antidepressant medication during pregnancy compared with children who were not exposed, using Cox proportional hazards regression analysis. Furthermore, we estimated the risk for autism spectrum disorder in a sibling design.
Results: Children exposed prenatally to antidepressants had an adjusted hazard ratio of 1.5 (95% confidence interval [CI] 1.2–1.9) for autism spectrum disorder compared with unexposed children. Restricting the analysis to children of women with a diagnosis of affective disorder, the adjusted hazard ratio was 1.2 (95% CI 0.7–2.1), and the risk was further reduced when exposed children were compared with their unexposed siblings (adjusted hazard ratio 1.1; 95% CI 0.5–2.3).
Conclusion: After controlling for important confounding factors, there was no significant association between prenatal exposure to antidepressant medication and autism spectrum disorders in the offspring.
Authors: Sørensen MJ, Grønborg TK, Christensen J, Parner ET, Vestergaard M, Schendel D, Pedersen LH
Published Date November 2013 Volume 2013:5(1) Pages 449 - 459
Received: 15 August 2013 These are actual dates the paper was submitted to, accepted for, and published in the journal.<br />These dates are only available for papers published since January 1, 2012
Accepted: 23 September 2013
Published: 15 November 2013
Merete Juul Sørensen,1 Therese Koops Grønborg,2 Jakob Christensen,3,4 Erik Thorlund Parner,2 Mogens Vestergaard,5,6 Diana Schendel,7 Lars Henning Pedersen8,9
1Regional Centre of Child and Adolescent Psychiatry, Aarhus University Hospital, Risskov, Denmark; 2Department of Public Health, Section of Biostatistics, Aarhus University, Aarhus, Denmark; 3Department of Neurology, Aarhus University Hospital, Aarhus, Denmark; 4Department of Clinical Pharmacology, 5Department of Public Health, Section of General Practice, 6Research unit for General Practice, Aarhus University, Aarhus, Denmark; 7Centers for Disease Control and Prevention, Atlanta, GA, USA; 8Danish Epidemiological Science Centre, Institute of Public Health, 9Department of Obstetrics and Gynecology, Institute of Clinical Medicine, Aarhus University, Aarhus, Denmark