Prenatal Antidepressant Exposures and Autism Spectrum Disorder or Traits: A Retrospective, Multi-Cohort Study

Patricia A. Brennan, Anne L. Dunlop, Lisa A. Croen, Lyndsay A. Avalos, Amy L. Salisbury, Alison E. Hipwell, Sara S. Nozadi, Sheela Sathyanarayana, Rosa M. Crum, Rashelle Musci, Mingyi Li, Xiuhong Li, Maxwell Mansolf, Thomas G. O’Connor, Amy J. Elliott, Nidhi Ghildayal, Pi I.D. Lin, Jenna L.N. Sprowles, Joseph B. Stanford, Casper BendixsenSally Ozonoff, Barry M. Lester, Coral L. Shuster, Kathi C. Huddleston, Jonathan Posner, Nigel Paneth

Research output: Contribution to journalArticlepeer-review

Abstract

Prenatal antidepressant exposure has been associated with increased risk for neurodevelopmental disorders in childhood, including autism spectrum disorder (ASD). The current study utilized multi-cohort data from the Environmental influences on Child Health Outcomes (ECHO) program (N = 3129) to test for this association, and determine whether the association remained after adjusting for maternal prenatal depression and other potential confounders. Antidepressants and a subset of selective serotonin reuptake inhibitors (SSRIs) were examined in relation to binary (e.g., diagnostic) and continuous measures of ASD and ASD related traits (e.g., social difficulties, behavior problems) in children 1.5 to 12 years of age. Child sex was tested as an effect modifier. While prenatal antidepressant exposure was associated with ASD related traits in univariate analyses, these associations were statistically non-significant in models that adjusted for prenatal maternal depression and other maternal and child characteristics. Sex assigned at birth was not an effect modifier for the prenatal antidepressant and child ASD relationship. Overall, we found no association between prenatal antidepressant exposures and ASD diagnoses or traits. Discontinuation of antidepressants in pregnancy does not appear to be warranted on the basis of increased risk for offspring ASD.

Original languageEnglish (US)
Pages (from-to)513-527
Number of pages15
JournalResearch on Child and Adolescent Psychopathology
Volume51
Issue number4
DOIs
StatePublished - Apr 2023

Keywords

  • Antidepressants
  • Autism spectrum disorder
  • Neurodevelopment
  • Prenatal

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Developmental and Educational Psychology

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