Do Antidepressants During Pregnancy Increase Autism Risk?
Previous studies have been conflicting as to whether exposure to serotonergic antidepressants during pregnancy may increase autism risk in offspring. There is the possibility that the underlying disorder, such as depression, is responsible for the increased autism risk in some papers, and not the medication. This study by Brown et al. (JAMA, 2017) explores the association between serotonergic antidepressant exposure during pregnancy and child autism spectrum disorder, with a major focus on addressing potential confounding factors.
Retrospective Cohort Study
35,906 singleton births with a mean gestational age of 38.7 weeks were surveyed. Incidence of autism spectrum disorder was 4.51/1000 person-years among children exposed to antidepressants (selective serotonin or serotonin-norepinephrine reuptake inhibitors) vs. 2.03/1000 person-years among children who were not exposed (between-group difference, 2.48 [95% CI, 2.33-2.62] per 1000 person-years; hazard ratio, 2.16 [95% CI, 1.64-2.86]; adjusted HR, 1.59 [95% CI, 1.17-2.17]. Using high-dimensional propensity score technique to account for covariates that could predict treatment (for example, does depression make you more likely to take this drug) the investigators found no association between serotonergic antidepressants and autism spectrum disorder (Hazard Ratio 1.61 [95% CI, 0.997-2.59]). The association was also not significant when exposed children were compared to unexposed siblings (Hazard Ratio, 1.60 [95% CI, 0.69-3.74]). Another paper appearing in JAMA in the same issue by Sujan et al. also found no association between first trimester antidepressant use and autism spectrum disorder and attention-deficit/hyperactivity (ADHD) disorder. The editorial by Oberlander and Zwaigenbaum concludes that addressing maternal mental health must be prioritized as depression is associated with developmental disturbances. Rather than focusing on antidepressants in isolation, research is needed to determine which patients and offspring could benefit from appropriate antidepressant treatment.
Please log in to access ObGFirst and the 2T US Atlas
Media - Internet
Computer System Requirements
OBG Project CME requires a modern web browser (Internet Explorer 10+, Mozilla Firefox, Apple Safari, Google Chrome, Microsoft Edge). Certain educational activities may require additional software to view multimedia, presentation, or printable versions of their content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Apple QuickTime, Adobe Acrobat, Microsoft PowerPoint, Windows Media Player, or Real Networks Real One Player.
Disclosure of Unlabeled Use
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.
The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.
Jointly provided by
NOT ENOUGH CME HOURS
It appears you don't have enough CME Hours to take this Post-Test. Feel free to buy additional CME hours or upgrade your current CME subscription plan