Use of Selective Serotonin Reuptake Inhibitors during Pregnancy and Risk of Autism

• Published in: The New England journal of medicine Vol. 369; no. 25; pp. 2406 - 2415
• Main Authors: Hviid, Anders, Melbye, Mads, Pasternak, Björn
• Format: Journal Article
• Language: English
• Published: Waltham, MA Massachusetts Medical Society 19.12.2013
• Subjects: Adult; Age; Antidepressants; Autism; Biological and medical sciences; Child clinical studies; Child Development Disorders, Pervasive - chemically induced; Child Development Disorders, Pervasive - epidemiology; Children & youth; Confidence Intervals; Denmark - epidemiology; Developmental disorders; Female; Follow-Up Studies; General aspects; Humans; Incidence; Infantile autism; Medical sciences; Offspring; Personal identification numbers; Pregnancy; Prenatal Exposure Delayed Effects; Prescriptions; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Registries; Risk; Serotonin; Serotonin uptake inhibitors; Serotonin Uptake Inhibitors - adverse effects; Denmark; Pregnancy; Medicine; Autism; Serotonin; Risk factor; Neurotransmitter; Developmental disorder
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJMoa1301449

In an analysis of Danish health registry data, use of SSRIs during pregnancy was not associated with a significantly increased risk of autism spectrum disorders in children. A relative risk as high as 1.6 could not be ruled out, a finding suggesting the need for further research. Selective serotonin reuptake inhibitors (SSRIs) are increasingly used in the treatment of depression and anxiety disorders. Currently, SSRIs appear to provide the best balance between efficacy and safety and are the preferred first-line treatment. Depression is common during pregnancy, and given the risks of untreated depression to mother and fetus, 1 , 2 pharmacologic treatment is warranted, often with SSRIs. 3 However, SSRIs cross the placenta, and a number of safety concerns have been raised. 4 These include concerns about birth defects, adverse obstetrical and neonatal outcomes, and effects on cognitive and behavioral development in childhood. Recently, autism spectrum disorders have been linked to . . .