Stud­ies: Use of anti-de­pres­sants in preg­nancy not linked to child autism

The Washington Times Daily - - NATION - BY LAURA KELLY

Two sep­a­rate stud­ies — one in Canada, one in the U.S. — have found that chil­dren whose mothers used an­tide­pres­sants dur­ing preg­nancy are not at an in­creased risk for autism or at­ten­tion deficit hy­per­ac­tiv­ity dis­or­der (ADHD).

The stud­ies, which were pub­lished Tues­day in the Journal of the Amer­i­can Med­i­cal As­so­ci­a­tion, con­tra­dict ear­lier stud­ies that had found a link be­tween an­tide­pres­sant use dur­ing preg­nancy and autism. The new stud­ies’ re­searchers used “so­phis­ti­cated sta­tis­ti­cal meth­ods to ad­just for pos­si­ble mea­sured and un­mea­sured con­found­ing fac­tors,” JAMA edi­tors wrote in an ed­i­to­rial.

In Canada, re­searchers used high di­men­sional propen­sity score (HDPS) anal­y­sis to “bal­ance ex­po­sure group dif­fer­ences,” the study’s au­thors wrote.

Dr. Si­mone Vigod, the study’s lead au­thor, said in an email to The Wash­ing­ton Times that with­out the sta­tis­ti­cal anal­y­sis, the re­sults would ap­pear to draw a link be­tween an­tide­pres­sants and autism.

“How­ever, when HDPS meth­ods were ap­plied, this was no longer the case,” she told The Times.

Dr. Vigod and her re­search team tracked 35,906 births over five years. Of 2,837 preg­nan­cies ex­posed to an­tide­pres­sants like Zoloft, Celexa or Prozac, about 2 per­cent of chil­dren were di­ag­nosed with autism spec­trum dis­or­der, the re­searchers found.

Us­ing HDPS, the re­searchers found that any as­so­ci­a­tion was not sig­nif­i­cant enough to con­clude that tak­ing an­tide­pres­sants dur­ing preg­nancy caused autism or ADHD.

Dr. Vigod said their re­sults are sup­ported by a cor­re­spond­ing sib­ling anal­y­sis, in which re­searchers found that two chil­dren born to the same mother had sim­i­lar risks for autism de­spite ex­po­sure to an­tide­pres­sants in utero. A third anal­y­sis ex­am­ined mothers who used an­tide­pres­sants be­fore but not dur­ing preg­nancy and found a sim­i­lar autism risk.

“Taken to­gether, these re­sults sug­gest that the in­creased risk for autism ob­served in pre­vi­ous stud­ies was more likely to be due to the un­der­ly­ing ma­ter­nal health con­di­tion or other fac­tors, rather than the med­i­ca­tion,” Dr. Vigod said.

In the other study, re­searchers in the U.S. and Sweden ob­served more than 1.5 mil­lion Swedish ba­bies whose mothers self-re­ported an­tide­pres­sant use dur­ing the first trimester. The chil­dren were born be­tween 1996 and 2012, and re­searchers fol­lowed up with them through 2013.

Be­sides ma­ter­nal an­tide­pres­sant use, re­searchers ex­am­ined a num­ber of fac­tors, in­clud­ing preg­nancy, ma­ter­nal and pa­ter­nal traits, and sta­ble fa­mil­ial char­ac­ter­is­tic shared by sib­lings, among oth­ers.

Re­searchers found that there was no in­creased risk for autism or ADHD but a small in­creased risk of pre­ma­ture birth.

“These re­sults are con­sis­tent with the hy­poth­e­sis that ge­netic fac­tors, fa­mil­ial en­vi­ron­men­tal fac­tors, or both ac­count for the pop­u­la­tion-wide as­so­ci­a­tions be­tween first-trimester an­tide­pres­sant ex­po­sure and these out­comes,” the au­thors wrote.

For Dr. Vigod, the con­clu­sions of the U.S.-Sweden study buoy her group’s find­ings.

“I be­lieve that it was very promis­ing that the study us­ing Swedish data — con­ducted en­tirely in­de­pen­dently from our study — came to a very sim­i­lar con­clu­sion,” Dr. Vigod said in an email. “Specif­i­cally, that in un­ad­justed and con­ven­tional analy­ses, it ap­peared as though there was a sig­nif­i­cant link be­tween an­tide­pres­sants and autism.

“Yet, in the sib­ling anal­y­sis (as in our study), the ef­fect was no longer ap­par­ent. It is very dif­fi­cult to have cer­tainty on this ques­tion be­cause the causes of autism are so mul­ti­fac­eted, but hav­ing such con­sis­tent find­ings arise from [two large pop­u­la­tion-based stud­ies — both of which had very rig­or­ous meth­ods — in­creases our con­fi­dence in the find­ings.”

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