The Association Between Prenatal Exposure to Antidepressants and Autism: Some Research and Public Health Aspects.

Ori Kapra,Ran Rotem,Raz Gross

doi:10.3389/fpsyt.2020.555740

Abstract

Use of antidepressants (ADs) in general, and in pregnant notwithstanding, has been increasing globally in recent decades. Associations with a wide range of adverse perinatal and childhood outcomes following prenatal ADs exposure have been observed in registry-based studies, with Autism Spectrum Disorders (ASD) frequently reported. Studies using animal models, sibling analyses, and negative control approaches, have linked dysfunctional serotonin metabolism with ASD, but did not convincingly tease apart the role of maternal mental health from that of ADs. As work to decipher the nature of the AD-ASD association continues, this review raises some public health concerns pertinent to a hypothetical conclusion that this association is causal, including the need to identify specific gestation periods with higher risk, the importance of precise assessment of the ASD potential prevention that might be attributed to AD discontinuation, and the estimation of risks associated with prenatal exposure to untreated depression.

Highlights

Use of antidepressants (ADs) in pregnancy results in fetal exposure to the medications, in concentrations that are 70–80% of maternal serum levels [1]
The potential risks of exposure to selective serotonin reuptake inhibitors (SSRIs) have to be evaluated while considering the potential effects of untreated maternal depression on the fetus
Even if a scientific consensus is reached that SSRIs are detrimental to the fetus, it is unlikely that medications carry a constant risk throughout the entire pregnancy, and critical gestation periods during which the fetus is potentially more vulnerable should be identified

Summary

Introduction

Use of antidepressants (ADs) in pregnancy results in fetal exposure to the medications, in concentrations that are 70–80% of maternal serum levels [1]. This conceptual ambiguity has not deterred the establishing of a consistent association with another public health concern, namely autism spectrum disorder (ASD) [12, 13].

Results

Conclusion