Another study linking antidepressant use in pregnancy and autism has just been published in the British Medical Journal, raising concerns about the safety of the medications in pregnancy

Depression in pregnancy is common and estimated to occur in 3-8% of pregnant women. The safety of the baby from antidepressant exposure during pregnancy has generated much debate in the past five years with concerns about an association with autism in the babies exposed to antidepressants in-utero. Conclusions have been  blurred because depression and other psychiatric indications for antidepressant use could be associated with autism through genetic and non-genetic pathways, not necessarily caused by the medication.

Importantly, no previous studies (and this study) did not find that antidepressants caused autism and the absolute risk of autism was small , 4.1% of children exposed to antidepressants in utero had autism compared with 2.9% of those with a maternal history of psychiatric disorder who were not exposed. The study also showed that 95% of women who took antidepressants did not have a child with autism. Variables such as parental age and family income were taken into account in the statistical analysis.

Several observation studies have previously reported associations between antidepressant use during pregnancy and autism in offspring, but whether the association is causal remains unclear. Research has also identified a greater than expected presence of psychiatric disorders in the families of children with autism, suggesting the presence of common underlying genetic factors.

The study does not change guidelines for appropriate current management of depression in pregnancy. It should not be interpreted as suggesting pregnant women should immediately cease their antidepressant medication , but demonstrates the need for further research to investigate the types of antidepressants as well as take into account the severity of the depression and other aspects of the mother's health. Study of the potential underlying biological mechanisms could help the understanding of modifiable mechanisms in the aetiology of autism. 

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