New Study Ties Antidepressant Use in Pregnancy to Autism in Boys

A major new study just released Monday reports that pregnant women taking antidepressants are at significant risk for giving birth to children with autism – especially if the baby is a boy. Results of this study were published online Monday, April 14 and in the May issue of Pediatrics.

According to the latest statistics from the Federal Centers for Disease Control and Prevention, one in 68 American children now has some form of autism

The study also found that boys whose mothers took SSRIs, such as Celexa, Lexapro, Paxil, Prozac and Zoloft, during pregnancy were also more likely to have developmental delays

First trimester selective serotonin reuptake inhibitors (SSRI) exposure was associated with more than a 300 percent increased risk.

SSRIs used during pregnancy cross the placenta and increase levels of the hormone serotonin in the fetus, as they do in the mother, the researchers said. Higher serotonin levels decrease depression. According to background information for the study, these antidepressants are used in about 4 percent of all pregnancies.

“We found prenatal SSRI exposure was almost three times as likely in boys with autism spectrum disorders (ASD) relative to typical development, with the greatest risk when exposure is during the first trimester,” said study co-author Li-Ching Lee, an associate scientist in the department of epidemiology at Johns Hopkins Bloomberg School of Public Health, in Baltimore

About one-in-three children with autism has higher than normal serotonin levels. Researchers think that these high levels may lead to the development of abnormal brain circuitry, which may play a role in the development of some autism symptoms, according to the study authors.

This current study included 966 mother-child pairs, who had been enrolled in the Childhood Autism Risks from Genetics and the Environment, or CHARGE, study. Nearly 800 children were males. The average age of the children studied was nearly 4 years old. About 500 of the children had an autism spectrum disorder, 154 had some type of developmental delay and 320 were typically developing children.

SSRI exposure was lowest in the typically developing children, with just 3.4 percent exposed during pregnancy. For those with autism, SSRI exposure occurred in 5.9 percent of pregnancies and SSRI exposure occurred in 5.2 percent of pregnancies for children with developmental delays.

Adam C. Urato, M.D., a maternal-fetal medicine specialist at Tufts Medical Center in Boston and MetroWest Medical Center in Framingham, Massachusetts explained the findings of the newest study.

“What is interesting about this study is that they analyzed the effects in boys and girls separately and found that it was the boys who had increased risk of autism spectrum disorder and developmental delays,” Urato said. “This finding is exactly what several of the animal studies have predicted – that male offspring have more neurobehavioral injury when exposed to SSRIs during development.

Urato also makes the point that the reported risk was very significant; “For autism spectrum disorder in boys, first trimester SSRI exposure was associated with more than a 300 percent increased risk. For developmental delay third trimester SSRI exposure was associated with almost a 500 percent increased risk.

Dr. Urato summarized the research and stated, “This paper adds to the mounting evidence from animal and human studies that the SSRI antidepressants when used in pregnancy are associated with neurobehavioral changes like autism and developmental delay in the exposed children. These antidepressant drugs are chemical compounds and we need to keep that in mind. From thalidomide to DES to cigarettes, history has taught us that exposing pregnant women to potentially toxic chemicals can lead to disastrous results.”

What should a pregnant woman with depression do instead of taking SSRIs?

“Depressed pregnant women should not be ignored,” Urato said. “They need good treatment and care, but the key issue is how to treat them.”

As Urato points out, there is a lot of scientific evidence that “non-drug approaches to depression, such as psychotherapy and exercise, are as good as or better for the treatment of depression in many women. This fact, along with all of the pregnancy complications associated with SSRIs(for example miscarriage, birth defects, preterm birth, and long-term problems like autism) should lead us to prioritize and emphasize the non-drug approaches to depression as a first-line approach.”

However, women should discuss their options with their physicians. All pregnant women should be advised of the dangers and risks before taking antidepressants, especially in the first trimester.

For more information, feel free to contact one of our Gacovino Lake attorneys at 1-800-246-HURT (4878).

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