A comprehensive analysis of over half a million pregnancies has found that taking antidepressants during pregnancy does not increase the risk of children developing autism or attention deficit hyperactivity disorder (ADHD). The study, conducted by researchers at the University of Hong Kong and published in The Lancet Psychiatry, analysed data from 37 existing studies that included 600,000 pregnant women who had taken antidepressants and 25 million women who had no antidepressant use during their pregnancies.
Key Findings
Before controlling for key factors such as pre-existing mental health conditions, the analysis found that antidepressant use by the mother during pregnancy was associated with a 35% increased risk of ADHD and a 69% increased risk of autism. However, when controlling for confounding factors such as the mother's mental health or other influencing factors like genetics, this risk became non-significant. The meta-analysis found no significant link between antidepressant use during pregnancy and a greater risk of autism and ADHD in children after accounting for these factors.
Expert Insights
Dr Wing-Chung Chang, a professor at the University of Hong Kong and lead author of the study, stated: "We know many parents-to-be worry about the potential impact of taking medication during pregnancy; our study provides reassuring evidence that commonly used antidepressants do not increase the risk of neurodevelopmental disorders such as autism and ADHD in children." He added that while all medications carry risks, stopping antidepressants during pregnancy can lead to relapse, and doctors and patients must carefully weigh the potential risks and benefits.
The study also found a small increase in the risk of autism and ADHD in children of women who had used antidepressants during pregnancy, but this risk disappeared when other factors were accounted for. The increased risk was also seen in children of fathers who took antidepressants and of mothers with antidepressant use before, but not during, pregnancy. This suggests that the risk is due to other factors, including genetic predisposition to conditions such as ADHD, autism, and mental health conditions.
Implications for Pregnant Women
James Walker, a professor emeritus of obstetrics and gynaecology at the University of Leeds, commented that the research helps to "cut through the noise" regarding concerns about medications during pregnancy. He said: "Women with moderate or severe depression should not stop their antidepressants in pregnancy out of fear of causing autism or ADHD. Depression that goes untreated in pregnancy carries real risks of its own, for the mother, the pregnancy and for the developing baby, including a higher chance of premature birth, postnatal depression and difficulties bonding with the baby." For milder depression, talking therapies and other non-medication approaches are usually tried first, in line with current guidelines.
Study Limitations
The study also found no difference in risk between high and low doses of antidepressants. Limitations included the lack of data on socioeconomic status, lifestyle risk factors, and low birthrate. Additionally, women prescribed antidepressants tend to have more severe depression, so some bias may remain even after controlling for factors such as mental health status.
