Depression

Antidepressants and pregnancy? This new study says they’re safe, with a few caveats.

antidepressants and pregnancy - blond woman holding belly

Summary: a new study on antidepressants and pregnancy found no strong links between the use of SSRI antidepressants during pregnancy and enhanced risk of autism spectrum disorder (ASD) or developmental delay (DD) in offspring.

The question of whether antidepressants and pregnancy can be safely combined has a long history.

Women with depression and other mood disorders are generally advised to continue taking antidepressant medications during pregnancy.

But many women still worry about the possible effects. The drugs are widely considered safe, but the effect of these medications on the unborn fetus has remained a topic of some concern.

But according to a new study on antidepressants and pregnancy published in the journal Biological Psychiatry , the use of a common class of antidepressants known as serotonin-selective reuptake inhibitors (SSRI) did not increase the risk for autism spectrum disorder (ASD) and developmental delay (DD) in offspring.

“Among mothers with psychiatric conditions during pregnancy, SSRI use was not related to ASD, suggesting that SSRIs may not raise the odds of ASD independently of their psychiatric indications,” the study says.

“However, ” it continues, “we observed that odds of DDs, particularly DDs without co-occurring ID [intellectual disability], were higher in children of mothers who used SSRIs during preconception and pregnancy.”

Previous links between autism and antidepressant use during pregnancy

Previous studies had found links between SSRI use and ASD in offspring. And ASD is associated with disrupted serotonergic pathways. But the question of whether the medication or the underlying conditions are responsible remained muddy.

“Our latest findings are good news for women managing psychiatric conditions such as depression and anxiety while pregnant,” said the study’s lead author Jennifer Ames.

Ames and colleagues used data from the Study to Explore Early Development (SEED), which collected information about the development of thousands of children born across the US between 2003 and 2011.

Antidepressants and pregnancy: a look at almost almost 5,000 offspring

The current analysis of SEED data included three groups of children. One group consisted of 1,367 children with ASD. A second group of 1,750 children had DD (developmental delay). A third group, the control group, consisted of 1,671 healthy children.

The children’s mothers were determined to have psychiatric disorders, and to have taken SSRIs during pregnancy based on self-report and on medical records.

About a third of mothers in the study had a psychiatric condition before or during pregnancy, and about a quarter of those took SSRIs or other antidepressants.

The findings indicated that the risk of ASD or DD was roughly doubled for children of mothers with a psychiatric disorder compared to those without.

Can I use antidepressants while pregnant?

This study of almost 5,000 children found that a mother’s use of SSRI antidepressants during pregnancy was not associated with increased risk of autism or developmental delay in her offspring.

However, the study notes, “in secondary analyses, we noted significant associations between prenatal SSRI exposure and DDs without co-occurring ID, a possible false-positive finding that needs confirmation in future work.”

“Parents have been concerned about the risks posed to infants when mothers take antidepressant medications,” said the editor of Biological Psychiatry John Krystal. “It is a big relief to see that maternal antidepressant consumption does not increase the risk for autism spectrum disorder or other neurodevelopmental disorders.”

However, he added, this study does confirm that maternal psychiatric disorders are associated with increased risk for autism spectrum disorder in offspring.

“Our study has some unique strengths such as including a large and demographically diverse group of mothers and children in the United States,” said Ames. It also included an analysis of specific subgroups of children with autism spectrum disorder and other developmental disorders, and an examination of multiple types of psychiatric conditions in the mothers.

“Maternal psychiatric conditions but not use of SSRIs during pregnancy were associated with increased risk of neurodevelopmental disorders in offspring,” the paper concludes.

The findings should provide some peace of mind for the estimated 6% of pregnant women in the US who take SSRI antidepressants.


Study: “Maternal psychiatric conditions, treatment with SSRIs, and neurodevelopmental disorders”
Authors: Jennifer Ames, Christine Ladd-Acosta, Daniele Fallin, Yinge Qian, Laura Schieve, Carolyn DiGuiseppi, Li-Ching Lee, Eric Kasten, Guoli Zhou, Jennifer Pinto-Martin, Ellen Howerton, Christopher Eaton, and Lisa Croen
Published in: Biological Psychiatry
Publication date: April 13, 2021
DOI: 10.1016/j.biopsych.2021.04.002
Image: by Regina Petkovic from Pixabay 

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