Prenatal Antidepressants and Autism

When I was pregnant, my doctor told me the general medical consensus was that the benefit of treating the mother's depression outweighed any known risks of fetal exposure to SSRIs.

Over the last five years, several studies have pointed to a possible connection between the use of SSRIs in pregnancy and the development of autism. The most recent, and most damning, came this week in the Archives of General Psychology. That study suggested that use of SSRIs during pregnancy - especially during the first trimester - can double or even triple the chances a baby will be diagnosed with an autism spectrum disorder. And it further noted that "No increase in risk was found for mothers with a history of mental health treatment in the absence of prenatal exposure to selective serotonin reuptake inhibitors," meaning it's likely that the problem lies in the drugs, not in the underlying condition that may or may not lead to the use of drugs.

That said, the vast majority of children with autism were not exposed to SSRIs in utero, and the vast majority of children exposed to SSRIs in utero do not go on to develop autism. There's a complicated mix of genetic and environmental factors at play here, and I look forward to the follow-up studies.

I believe I made the right decision to continue to treat my depression during my pregnancy. According to the American Pregnancy Association,
Depression that is not treated can have potential dangerous risks to the mother and baby. Untreated depression can lead to poor nutrition, drinking, smoking, and suicidal behavior, which can then cause premature birth, low birth weight, and developmental problems. A woman who is depressed often does not have the strength or desire to adequately care for herself or her developing baby. Babies born to mothers who are depressed may also be less active, show less attention and are more irritable and agitated than babies born to moms who are not depressed. This is why getting the right help is so important for both mom and baby. Great risks, indeed.

I must keep reminding myself of those risks so I don't fall into the tempting spiral of self-blame for my child's challenges.