Antidepressants in pregnancy do not raise children’s risk of autism or ADHD, study finds | Pregnancy
Taking antidepressants during pregnancy does not increase the risk of children developing autism or attention deficit hyperactivity disorder (ADHD), according to an analysis of more than half a million pregnancies.
The study, led by researchers at the University of Hong Kong and published in the Lancet Psychiatry, analyzed data from 37 existing studies including 600,000 pregnant women who took antidepressants and 25 million women who took no antidepressants during pregnancy.
Before taking into account key factors such as pre-existing mental health conditions, the analysis found that maternal use of antidepressants during pregnancy was associated with a 35% increased risk of ADHD and a 69% increased risk of autism.
However, after controlling for confounding factors such as pre-existing mental health conditions, this risk became non-significant. This means that the meta-analysis found no significant link between antidepressant use during pregnancy and a higher risk of autism and ADHD in children, after taking into account the mother’s mental health or other influencing factors such as genetics.
Dr Wing-Chung Chang, professor at the University of Hong Kong and lead author of the study, said: “We know that many expectant parents are concerned about the potential impact of taking medications during pregnancy; our study provides reassuring evidence that commonly used antidepressants do not increase the risk of neurodevelopmental disorders such as autism and ADHD in children.
“While all medications carry risks, stopping antidepressants during pregnancy also carries an increased risk of relapse. Therefore, for women with moderate to severe depression, doctors and patients should carefully weigh the potential risks and benefits of continuing antidepressant therapy during pregnancy against the potential harms of untreated depression.
“Although our study found a slight increase in the risk of autism and ADHD in children of women who used antidepressants during pregnancy, it also found that this risk disappeared when we took other factors into account. The increased risk was also seen in children of fathers who took antidepressants and mothers taking antidepressants before, but not during, pregnancy.
“Together, this suggests that it is not the antidepressants themselves that cause an increased risk of autism and ADHD, but that this is more likely to be due to other factors, including a genetic predisposition to conditions such as ADHD, autism and mental health problems.”
The study also found no difference in risk between high and low doses of antidepressants. Limitations of the study included lack of data on socioeconomic status, lifestyle risk factors, and low birth rate. Additionally, women who are prescribed antidepressants tend to have more severe depression than those who are not, so some bias may persist even after accounting for factors such as mental health status.
James Walker, emeritus professor of obstetrics and gynecology at the University of Leeds, said the research had helped “cut through the noise” about recent concerns about whether medicines taken by mothers during pregnancy could affect their babies.
“The practical message is simple,” Walker said. “Women with moderate or severe depression should not stop their antidepressants during pregnancy for fear of causing autism or ADHD. Depression that is left untreated during pregnancy carries real risks, for the mother, the pregnancy and for the developing baby, including a higher risk of premature birth, postnatal depression and difficulty bonding with the baby. For milder depression, talking therapies and other non-drug approaches are usually tried first, in accordance with current guidelines As always, decisions during pregnancy are personal and should be made with a clinician who knows the woman’s history.
