title: Prenatal antidepressant exposure and the risk of autism spectrum disorders in children. Are we looking at the fall of Gods?
abstract: Recent information suggests that antenatal exposure to psychotropics may impair child neurodevelopment. Thus, aim of this review is to examine systematically available literature investigating potential associations between prenatal use of selective serotonin reuptake inhibitors (SSRIs) and the risk of autism spectrum disorders (ASDs).
  
  
  METHODS
  Medical literature published in English since 1988 identified using MEDLINE/PubMed, EMBASE, SCOPUS, and The Cochrane Library. Search terms: antidepressants, autism (spectrum disorders), childhood, children, neurodevelopment, pregnancy, SSRIs. Searches were updated until March 5, 2015.
  
  
  RESULTS
  Six out of eight reviewed articles confirm an association between antenatal SSRI exposure and an increased risk of ASDs in children. However, the epidemiologic evidence on the link between prenatal SSRI exposure and ASD risk must still be cautiously interpreted, because of potential biases of analyzed research.
  
  
  CONCLUSIONS
  Main limitations of reviewed studies include: lack of directly validated clinical evaluation, impossibility to identify women who really took the prescribed medications during pregnancy, no assessment of severity and course of symptoms in relation to the pregnancy, lack of information about unhealthy prenatal lifestyle behaviors.
  
  
  CONCLUSIONS
  Despite such limitations, available data show that some signal exists suggesting that antenatal exposure to SSRIs may increase the risk of ASDs. Thus, there is an urgent need for further, large, well-designed research finalized to definitively assess the existence and the magnitude of this severe risk, thus confirming or denying that we are truly looking at "the fall of Gods", since for many years SSRIs have been considered the first-choice agents for treating antenatal depression (Gentile, 2014; Gentile, 2011a; Gentile, 2005).
authors.affiliation: Department of Mental Health ASL Salerno Mental Health Center, n. 63, Piazza Galdi, 841013 Cava de׳ Tirreni, Salerno, Italy; University of Naples, Medical School "Federico II", Department of Neurosciences - Perinatal Psychiatry, Via S. Pansini, 5, 80131 Naples, Italy. Electronic address: salvatore_gentile@alice.it.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Gentile
mesh_terms: D000293:Adolescent; D000928:Antidepressive Agents / Q000627:therapeutic use*; D000067877:Autism Spectrum Disorder / Q000453:epidemiology*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003866:Depressive Disorder / Q000188:drug therapy* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology*; D012107:Research Design; D012306:Risk; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use
chemical_list: D000928:Antidepressive Agents; D017367:Selective Serotonin Reuptake Inhibitors
keywords: Antidepressants; Autism spectrum disorders; Neurodevelopment; Pregnancy; SSRIs; Safety