Abstract
Background.Previous studies have examined if maternal antidepressant medication during pregnancy increase the risk of autism spectrum disorder (ASD) in the offspring, but the results have been conflicting.Methods.In a population-based cohort of 179 007 children born in 2006 and 2007 and followed through 2014 when aged 7 and 8, we estimated relative risks (RRs) of ASD and 95% confidence intervals (CIs) from Cox regression in children exposed to any antidepressant medication during pregnancy, and nine specific antidepressant drugs. Analyses were adjusted for potential confounders and were conducted in the full population sample, and in a clinically relevant sub-sample of mothers with at least one diagnosis of depression or anxiety during life.Results.The adjusted RR of ASD in children of mothers who used antidepressant medication during pregnancy was estimated at 1.23 (95% CI 0.96–1.57), and at 1.07 (95% CI 0.80–1.43) in women with a history of depression or anxiety. Analyses of specific antidepressants initially revealed increased RRs of offspring ASD confined to citalopram and escitalopram (RR: 1.47; 95% CI 0.92–2.35) and clomipramine (RR: 2.86; 95% CI 1.04–7.82).Conclusion.Medication with antidepressants during pregnancy does not appear to be causally associated with an increased risk of ASD in the offspring. Instead, the results suggest that the association is explained by factors related to the underlying susceptibility to psychiatric disorders. Based on these findings, the risk of ASD in the offspring should not be a consideration to withhold treatment with commonly used antidepressant drugs from pregnant women.
Highlights
It has been suggested that antidepressant medication in pregnant women may increase the risk of autism spectrum disorder (ASD) in the offspring
In this population-based, prospective cohort study of 179 007 children and their parents, we observed an increased Relative risks (RRs) of ASD in offspring of mothers treated with antidepressant medication during pregnancy compared with offspring of mothers not treated with antidepressants during pregnancy
The results of the present study strongly suggest that the associations between antidepressant treatment during pregnancy and offspring ASD are gradually attenuated with increasing covariate adjustment
Summary
It has been suggested that antidepressant medication in pregnant women may increase the risk of autism spectrum disorder (ASD) in the offspring. An association between maternal antidepressant medication during pregnancy and offspring ASD could either be due to: (1) a direct effect of the drug or (2) factors that confound the antidepressant treatment and the outcome studied. Previous studies have examined if maternal antidepressant medication during pregnancy increase the risk of autism spectrum disorder (ASD) in the offspring, but the results have been conflicting
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