Severity of mother’s depression not antidepressant drug use during pregnancy causes autism, ADHD: Study

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Pregnant woman poses for photo
Pregnant Sabine Heinrich (36) is pictured while posing in her living room in Eichenau December 12, 2012. The birth of her second child was planned for January 12, 2013. Reuters/Michaela Rehle

The increase in the risk of autism and attention-deficit hyperactivity disorder (ADHD) in children may be due to the severity of the mother’s depression alone and not from exposure to antidepressants during pregnancy, a new study suggests. Analysis of medical records of up to 6,000 children shows no evidence that exposure to antidepressants during pregnancy leads to higher risk of autism and ADHD.

Depression is known to significantly contribute to the development of the conditions and other neuropsychiatric disorders. However, some studies that have associated autism and ADHD to antidepressants did not consider the differences between mothers who take antidepressants and those who don't, according to researchers from the Massachusetts General Hospital (MGH).

They noted that those taking antidepressants are more likely to be experiencing more severe illness that might affected the development of the disorders. The findings come from the analysis of records from three Massachusetts health care systems in the US.

The new study, published in Translational Psychiatry, shows the risk of both autism and ADHD increased when mothers used antidepressants before being pregnant; however. the use of the drugs during pregnancy did not increase the incidence of the conditions.

"The fact that we now have found, in two large case-control studies, no increase in the risk for autism with antidepressant use itself should be very reassuring," said Dr Roy Perlis, from the MGH Department of Psychiatry.

Researchers also found that women who had taken the treatment, known as maternal psychotherapy before pregnancy, might have more serious depression which significantly increased the risk of either autism or ADHD. This supports the hypothesis that studies suggesting increased incidence of the conditions “actually reflected the risk conferred by maternal depression itself.”

"While taking any medicine during pregnancy can be a difficult decision, we hope the results of our two papers - which now cover more than 2,500 children with autism and almost 4,000 with ADHD - will provide some reassurance to women concerned about getting treatment for depression or anxiety during pregnancy," Perlis said. "We want women and the clinicians working with them to be as informed as possible when making this decision."