title: Antidepressant use during pregnancy and childhood autism spectrum disorders.
abstract: BACKGROUND
  The prevalence of autism spectrum disorders (ASDs) has increased over recent years. Use of antidepressant medications during pregnancy also shows a secular increase in recent decades, prompting concerns that prenatal exposure may contribute to increased risk of ASD.
  
  
  OBJECTIVE
  To systematically evaluate whether prenatal exposure to antidepressant medications is associated with increased risk of ASD.
  
  
  METHODS
  Population-based case-control study. Medical records were used to ascertain case children and control children and to derive prospectively recorded information on mothers' use of antidepressant medications, mental health history of mothers, and demographic and medical covariates.
  
  
  METHODS
  The Kaiser Permanente Medical Care Program in Northern California.
  
  
  METHODS
  A total of 298 case children with ASD (and their mothers) and 1507 randomly selected control children (and their mothers) drawn from the membership of the Kaiser Permanente Medical Care Program in Northern California.
  
  
  METHODS
  ASDs.
  
  
  RESULTS
  Prenatal exposure to antidepressant medications was reported for 20 case children (6.7%) and 50 control children (3.3%). In adjusted logistic regression models, we found a 2-fold increased risk of ASD associated with treatment with selective serotonin reuptake inhibitors by the mother during the year before delivery (adjusted odds ratio, 2.2 [95% confidence interval, 1.2-4.3]), with the strongest effect associated with treatment during the first trimester (adjusted odds ratio, 3.8 [95% confidence interval, 1.8-7.8]). 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.
  
  
  CONCLUSIONS
  Although the number of children exposed prenatally to selective serotonin reuptake inhibitors in this population was low, results suggest that exposure, especially during the first trimester, may modestly increase the risk of ASD. The potential risk associated with exposure must be balanced with the risk to the mother or fetus of untreated mental health disorders. Further studies are needed to replicate and extend these findings.
authors: Division of Research, Kaiser Permanente Northern California, Oakland, CA 94612, USA. lisa.a.croen@kp.org
authors: Lisa A
authors: LA
authors: Croen
authors: Judith K
authors: JK
authors: Grether
authors: Cathleen K
authors: CK
authors: Yoshida
authors: Roxana
authors: R
authors: Odouli
authors: Victoria
authors: V
authors: Hendrick
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D002648:Child; D002659:Child Development Disorders, Pervasive / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000378:metabolism; D015986:Confounding Factors, Epidemiologic; D003625:Data Collection / Q000379:methods; D003863:Depression / Q000175:diagnosis / Q000188:drug therapy*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011297:Prenatal Exposure Delayed Effects / Q000378:metabolism*; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D012701:Serotonin / Q000378:metabolism*; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics
chemical_list: D012701:Serotonin; D017367:Selective Serotonin Reuptake Inhibitors