A meta-analysis rules out the relationship between antidepressants during pregnancy and autism

This is the main conclusion of a systematic review and meta-analysis published in the journal The Lancet Psychiatry.

To reach their conclusions, the authors pooled data from 37 studies that included more than 600,000 pregnant women taking antidepressants and almost 25 million pregnancies without the use of these drugs.

For the researchers, this new meta-analysis provides “the best evidence” to date that the small increased risk of autism or ADHD in children of women who used antidepressants in pregnancy – identified in past studies – is not caused by the medication.

“Our study provides reassuring evidence that commonly used antidepressants do not increase the risk of neurodevelopmental disorders (…)”, summarizes Wing-Chung Chang, from the University of Hong Kong.

The researcher notes that although the analysis found a small increase in the risk of autism and ADHD in the children of women who had taken antidepressants during pregnancy, it also observed that this risk disappeared when other factors were taken into account.

This link, for example, was also seen with the use of antidepressants in mothers before conception and in fathers coinciding with pregnancy, which points to the mental health and genetics of the parents rather than the medication itself.

“On the whole, This suggests that it is not antidepressants themselves that cause an increased risk of autism and ADHD, but rather it is more likely due to other factors, including genetic predisposition to disorders such as these and mental health disorders.”concludes Chang.

The evidence therefore suggests a link between either parent having a mental health disorder and a slightly increased risk of ADHD or autism.

In addition to genetic factors, this relationship could be explained by the family and social environment, since continuous family stress, changes in family functioning and differences in parental behavior and care of their children can influence neurological development, details Joe Kwun-Nam Chan, also from the University of Hong Kong.

“It is necessary to guarantee that both parents have access to support and treatment for mental health disorders, for their own good and to promote the neurological development of their child,” he emphasizes in a statement.

The research found no difference in risk between high and low doses of antidepressants.

Among studies whose analyzes were limited to mothers with mental health disorders, none of the selective serotonin reuptake inhibitors were found to be associated; only amitriptyline/nortriptyline.

Therefore, women treated with these may have more severe, chronic or complex underlying mental health disorders than those receiving more common antidepressants, which could influence the association between amitriptyline/nortriptyline and increased risk of ADHD and autism.

On the other hand, The researchers point out some limitations of the work, including the lack of data on important variables such as socioeconomic status, lifestyle risk factors, and low birth weight.

In a related comment, Lisa Vitte, Emmanuel Devouche and Gisele Apter of the University of Rouen Normandy in France, who were not involved in the study, say that it provides new knowledge and confirms some of the previous findings on the use of antidepressants during pregnancy: that they should continue to be taken, as they protect maternal mental health and do not harm fetal development.

“This result has a considerable impact after numerous contradictory and controversial studies,” they emphasize.