Maternal psychiatric conditions were associated with an increased risk of autism spectrum disorder (ASD) in offspring, but the use of selective serotonin reuptake inhibitors (SSRIs) during pregnancy was not, in a diverse sample of US mothers and children. Researchers published the findings online ahead of print in Biological Psychiatry.

“These results suggest that prenatal exposure to SSRIs is not associated with increased odds of ASD among children of women with a psychiatric indication for treatment,” researchers wrote. “However, in secondary analyses, we noted significant associations between prenatal SSRI exposure and developmental delays or disorders (DDs) without co-occurring intellectual disability, a possible false-positive finding that needs confirmation in future work.”

For the investigation, researchers used data from the Study to Explore Early Development, which collected information about the development of children born across the US between 2003 and 2011. The current study looked at data for 3 groups: 1367 children with ASD, 1750 children with DDs, and 1671 healthy children. Self-report and medical records determined maternal psychiatric disorders and use of SSRIs during pregnancy. Approximately one third of mothers had psychiatric conditions before or during pregnancy; among them, approximately one quarter took SSRIs or other antidepressants.

Post Partum Risk Linked With Altered Brain Connectivity

The adjusted odds of having a child with ASD were nearly 2-fold higher for mothers with a psychiatric condition during pregnancy, regardless of SSRI use, compared with mothers without a psychiatric condition, according to the study.

However, when the analysis was restricted to mothers with psychiatric conditions, SSRI use was not significantly linked with ASD in offspring: researchers reported an adjusted odds ratio of 1.14. Primary findings for DDs were similar, they added.

“Our latest findings are good news for women managing psychiatric conditions such as depression and anxiety while pregnant,” said study lead author Jennifer Ames, PhD, of Kaiser Permanente Northern California, Oakland, California, “and are consistent with a growing body of research that’s trying to better disentangle the separate relationships of the mother’s SSRI treatment and psychiatric indications during pregnancy with child neurodevelopment.”

—Jolynn Tumolo

References

Ames JL, Ladd-Acosta C, Fallin MD, et al. Maternal psychiatric conditions, treatment with selective serotonin reuptake inhibitors, and neurodevelopmental disorders. Biol Psychiatry. Published online April 14, 2021. doi: 10.1016/j.biopsych.2021.04.002

Antidepressants safe during pregnancy. News release. Elsevier. June 24, 2021. Accessed July 23, 2021.