Journal article
Antidepressants during pregnancy and autism in offspring: population based cohort study
BMJ, v 358(8115), pp j2811-j2811
19 Jul 2017
PMID: 28724519
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Objectives To study the association between maternal use of antidepressants during pregnancy and autism spectrum disorder (ASD) in offspring.Design Observational prospective cohort study with regression methods, propensity score matching, sibling controls, and negative control comparison.Setting Stockholm County, Sweden.Participants 254 610 individuals aged 4-17, including 5378 with autism, living in Stockholm County in 2001-11 who were born to mothers who did not take antidepressants and did not have any psychiatric disorder, mothers who took antidepressants during pregnancy, or mothers with psychiatric disorders who did not take antidepressants during pregnancy. Maternal antidepressant use was recorded during first antenatal interview or determined from prescription records.Main outcome measure Offspring diagnosis of autism spectrum disorder, with and without intellectual disability.Results Of the 3342 children exposed to antidepressants during pregnancy, 4.1% (n=136) had a diagnosis of autism compared with a 2.9% prevalence (n=353) in 12 325 children not exposed to antidepressants whose mothers had a history of a psychiatric disorder (adjusted odds ratio 1.45, 95% confidence interval 1.13 to 1.85). Propensity score analysis led to similar results. The results of a sibling control analysis were in the same direction, although with wider confidence intervals. In a negative control comparison, there was no evidence of any increased risk of autism in children whose fathers were prescribed antidepressants during the mothers’ pregnancy (1.13, 0.68 to 1.88). In all analyses, the risk increase concerned only autism without intellectual disability.Conclusions The association between antidepressant use during pregnancy and autism, particularly autism without intellectual disability, might not solely be a byproduct of confounding. Study of the potential underlying biological mechanisms could help the understanding of modifiable mechanisms in the aetiology of autism. Importantly, the absolute risk of autism was small, and, hypothetically, if no pregnant women took antidepressants, the number of cases that could potentially be prevented would be small.
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Details
- Title
- Antidepressants during pregnancy and autism in offspring: population based cohort study
- Creators
- Dheeraj Rai - Division of Psychiatry, University College London, London, UKBrian K Lee - Division of Psychiatry, University College London, London, UKChristina Dalman - Division of Psychiatry, University College London, London, UKCraig Newschaffer - Division of Psychiatry, University College London, London, UKGlyn Lewis - Division of Psychiatry, University College London, London, UKCecilia Magnusson - Division of Psychiatry, University College London, London, UK
- Publication Details
- BMJ, v 358(8115), pp j2811-j2811
- Publisher
- British Medical Journal (BMJ)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Epidemiology and Biostatistics; A.J. Drexel Autism Institute
- Web of Science ID
- WOS:000406318300001
- Scopus ID
- 2-s2.0-85025444715
- Other Identifier
- 991014877678304721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Psychiatry