There’s been controversy for years over whether the use of common antidepressants by women during their pregnancies might raise the odds of mental health issues in their children.
Now, a study involving more than 13,000 children finds no rise in the risk of autism in children whose mothers used an antidepressant while pregnant, but some data suggesting a heightened risk of attention-deficit/hyperactivity disorder (ADHD) in these youngsters.
The findings challenge prior research pointing to a link between exposure to antidepressants in the womb and a greater risk of autism. Instead, severe maternal depression may be the risk factor boosting a child’s odds for autism — not any antidepressant a woman took during her pregnancy, the new study’s authors said.
“We know that untreated depression can pose serious health risks to both a mother and child, so it’s important that women being treated with antidepressants who become pregnant, or who are thinking about becoming pregnant, know that these medications will not increase their child’s risk of autism,” study senior author Dr. Roy Perlis, of the department of psychiatry at Massachusetts General Hospital in Boston, said in a hospital news release.
In the new study, Perlis and colleagues analyzed data from thousands of children with either an autism spectrum disorder or ADHD and thousands more children without either disorder. In total, they looked at the antidepressant use of mothers of 1,400 children diagnosed with an autism spectrum disorder and 4,000 kids without the condition. The team did the same for 2,250 youngsters with ADHD and 5,600 without.
Initial results suggested that taking antidepressants during pregnancy did increase the risk of both autism and ADHD in children. However, after the researchers adjusted the data for the severity of the mothers’ depression, the link between antidepressants and autism became insignificant.
However, even after adjusting for depression severity among mothers, the link between antidepressants and ADHD risk was still there, the study authors said. But because the study simply looked at past data, it could only point to an association, it could not prove cause and effect.
One psychiatrist believes the findings highlight the importance of treating women with depression, even during their pregnancy.
“Up to one in five pregnant women suffer from depression, and the risks to them include prematurity, low birth weight, pre-eclampsia, postpartum depression and suicidality,” said Dr. Deepan Singh, a child, adolescent and adult psychiatrist at Winthrop-University Hospital in Mineola, N.Y.
“Left untreated, these women are more likely to have relapses of depression as well as engage in high-risk behaviors such as substance abuse,” he added.
The new study “gives hope and confidence to the multitudes of suffering women who have feared the possibility of autism developing due to prenatal exposure to antidepressants,” Singh said. “In fact, the article demonstrates that treatment might lower this risk.”
While decisions around how to treat depression are best left to a discussion between a woman and her physician, Singh believes that, overall, “the risks of untreated depression outweigh the possibility of harm from treatment.”
Dr. Andrew Adesman is chief of developmental and behavioral pediatrics at Cohen Children’s Medical Center of New York, in New Hyde Park, N.Y. He also called the study “reassuring” for women worried about the potential for autism in their children. And Adesman said that the finding on ADHD risk “needs to be studied further to be sure that it is not a research artifact caused by some confounding variable.”
As for study author Perlis, he reminded women that “there are a range of options — medication and non-medication — for treating depression and anxiety in pregnancy. But if antidepressants are needed, I hope parents can feel reassured about their safety.”