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Parental depression, maternal antidepressant use during pregnancy, and risk of autism spectrum disorders: population based case-control study
Journal article   Open access   Peer reviewed

Parental depression, maternal antidepressant use during pregnancy, and risk of autism spectrum disorders: population based case-control study

Dheeraj Rai, Brian K Lee, Christina Dalman, Jean Golding, Glyn Lewis and Cecilia Magnusson
BMJ (Clinical research ed.), v 346(7907), p12
19 Apr 2013
DOI: https://doi.org/10.1136/bmj.f2059
PMID: 23604083
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://doi.org/10.1136/bmj.f2059View
Published, Version of Record (VoR) Open

Abstract

Humans Middle Aged Child, Preschool Depressive Disorder - drug therapy Infant Male Case-Control Studies Young Adult Sweden Parents - psychology Adult Female Depressive Disorder - epidemiology Child Intellectual Disability - epidemiology Child Development Disorders, Pervasive - epidemiology Risk Factors Serotonin Uptake Inhibitors - therapeutic use Pregnancy Complications - drug therapy Antidepressive Agents - therapeutic use Pregnancy Pregnancy Complications - psychology Child Development Disorders, Pervasive - psychology Depressive Disorder - complications Adolescent Pregnancy Complications - epidemiology Cohort Studies
To study the association between parental depression and maternal antidepressant use during pregnancy with autism spectrum disorders in offspring. Population based nested case-control study. Stockholm County, Sweden, 2001-07. 4429 cases of autism spectrum disorder (1828 with and 2601 without intellectual disability) and 43,277 age and sex matched controls in the full sample (1679 cases of autism spectrum disorder and 16,845 controls with data on maternal antidepressant use nested within a cohort (n=589,114) of young people aged 0-17 years. A diagnosis of autism spectrum disorder, with or without intellectual disability. Parental depression and other characteristics prospectively recorded in administrative registers before the birth of the child. Maternal antidepressant use, recorded at the first antenatal interview, was available for children born from 1995 onwards. A history of maternal (adjusted odds ratio 1.49, 95% confidence interval 1.08 to 2.08) but not paternal depression was associated with an increased risk of autism spectrum disorders in offspring. In the subsample with available data on drugs, this association was confined to women reporting antidepressant use during pregnancy (3.34, 1.50 to 7.47, P=0.003), irrespective of whether selective serotonin reuptake inhibitors (SSRIs) or non-selective monoamine reuptake inhibitors were reported. All associations were higher in cases of autism without intellectual disability, there being no evidence of an increased risk of autism with intellectual disability. Assuming an unconfounded, causal association, antidepressant use during pregnancy explained 0.6% of the cases of autism spectrum disorder. In utero exposure to both SSRIs and non-selective monoamine reuptake inhibitors (tricyclic antidepressants) was associated with an increased risk of autism spectrum disorders, particularly without intellectual disability. Whether this association is causal or reflects the risk of autism with severe depression during pregnancy requires further research. However, assuming causality, antidepressant use during pregnancy is unlikely to have contributed significantly towards the dramatic increase in observed prevalence of autism spectrum disorders as it explained less than 1% of cases.

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206 citations in Web of Science
306 citations in Scopus

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UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#5 Gender Equality
#3 Good Health and Well-Being

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Collaboration types
Domestic collaboration
International collaboration
Web of Science research areas
Psychiatry
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