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New Evidence: Antidepressants During Early Pregnancy May Not Increase Risk of ADHD and Autism

A new study suggests that a mother’s antidepressant use during the first trimester of pregnancy may not increase the risk of ADHD or autism among her children, as previously thought.

May 2, 2017

A large population study found that children whose mothers took antidepressants during the first trimester of pregnancy experienced no increased risk for ADHD or autism — contradicting previous research that found a strong association between the two conditions and the medication.

The study, published in April in the Journal of the American Medical Association, was conducted by researchers at the University of Indiana, working in partnership with the Karolinska Institute in Sweden and the Harvard T.H. Chan School of Public Health. Researchers examined all births in Sweden from 1996 to 2012 — more than 1.5 million in total — matching each with data about adult antidepressant prescriptions (which consisted primarily of SSRIs), ADHD and autism diagnoses in children, and the socioeconomic status of the parents.

An uncontrolled analysis did find an association between the mother’s antidepressant use and an increased risk of ADHD or autism, the researchers said. But once they controlled for other factors that could lead to those outcomes — like the mother’s age or the family’s financial situation — they found no increased risk of ADHD or autism among children whose mothers took antidepressants during the first trimester of pregnancy. Antidepressant use during pregnancy was associated with a slightly increased risk of premature birth, the researchers said.

“To our knowledge, this is one of the strongest studies to show that exposure to antidepressants during early pregnancy is not associated with autism, ADHD, or poor fetal growth when taking into account the factors that lead to medication use in the first place,” said study leader Dr. Brian D’Onofrio.

The study’s results are especially promising because of its large size, the researchers said, and because they were able to examine siblings within the same family — and directly compare outcomes when the mother took antidepressants during one pregnancy, but not another.

The study did find that the father’s antidepressant use, as well as the mother’s use before (but not during) her pregnancy, were both associated with an increased risk for ADHD or autism in the offspring — leading researchers to believe that a family’s genetic makeup and history of depression were bigger factors than were the antidepressants themselves.

“Balancing the risks and benefits of using antidepressants during pregnancy is an extremely difficult decision that every woman should make in consultation with her doctor,” D’Onofrio said. “However, this study suggests use of these medications while pregnant may be safer than previously thought.”

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