title: Antidepressant exposure in pregnancy and risk of autism spectrum disorders.
abstract: BACKGROUND
  Both the use of antidepressant medication during pregnancy and the prevalence of autism spectrum disorder have increased during recent years. A causal link has recently been suggested, but the association may be confounded by the underlying indication for antidepressant use. We investigated the association between maternal use of antidepressant medication in pregnancy and autism, controlling for potential confounding factors.
  
  
  METHODS
  We identified all children born alive in Denmark 1996-2006 (n=668,468) and their parents in the Danish Civil Registration System. We obtained information on the mother's prescriptions filled during pregnancy from the Danish National Prescription Registry, and on diagnoses of autism spectrum disorders in the children and diagnoses of psychiatric disorders in the parents from the Danish Psychiatric Central Register. In a cohort analysis, we estimated hazard ratios of autism spectrum disorders in children exposed to antidepressant medication during pregnancy compared with children who were not exposed, using Cox proportional hazards regression analysis. Furthermore, we estimated the risk for autism spectrum disorder in a sibling design.
  
  
  RESULTS
  Children exposed prenatally to antidepressants had an adjusted hazard ratio of 1.5 (95% confidence interval [CI] 1.2-1.9) for autism spectrum disorder compared with unexposed children. Restricting the analysis to children of women with a diagnosis of affective disorder, the adjusted hazard ratio was 1.2 (95% CI 0.7-2.1), and the risk was further reduced when exposed children were compared with their unexposed siblings (adjusted hazard ratio 1.1; 95% CI 0.5-2.3).
  
  
  CONCLUSIONS
  After controlling for important confounding factors, there was no significant association between prenatal exposure to antidepressant medication and autism spectrum disorders in the offspring.
authors.affiliation: Regional Centre of Child and Adolescent Psychiatry, Aarhus University Hospital, Risskov, Denmark.
authors.forename: Merete Juul
authors.initials: MJ
authors.lastname: Sørensen
authors.forename: Therese Koops
authors.initials: TK
authors.lastname: Grønborg
authors.forename: Jakob
authors.initials: J
authors.lastname: Christensen
authors.forename: Erik Thorlund
authors.initials: ET
authors.lastname: Parner
authors.forename: Mogens
authors.initials: M
authors.lastname: Vestergaard
authors.forename: Diana
authors.initials: D
authors.lastname: Schendel
authors.forename: Lars Henning
authors.initials: LH
authors.lastname: Pedersen
keywords: antidepressants; autism spectrum disorder; childhood autism; depression; autism; pregnancy