Lisa A. Croen, PhD; Judith K. Grether, PhD; Cathleen K. Yoshida, MS; Roxana Odouli, MSPH; Victoria Hendrick, MD July 2011
Arch Gen Psychiatry. Published online July 4, 2011. doi:10.1001/archgenpsychiatry.2011.73
Context 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.
Design 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.
Setting The Kaiser Permanente Medical Care Program in Northern California.
Participants 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.
Main Outcome Measures 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.
Conclusion 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.
Author Affiliations: Division of Research, Kaiser Permanente Northern California, Oakland (Dr Croen and Mss Yoshida and Odouli), Environmental Health Investigations Branch, California Department of Public Health, Richmond (Dr Grether), and Department of Psychiatry, Neuropsychiatric Institute and Hospital, University of California, Los Angeles (Dr Hendrick)."
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Who do women trust now?
Five Years Ago
July 2006
Financial ties to industry cloud depression study
" For pregnant women considering whether to continue taking antidepressant drugs, a study in a February issue of the Journal of the American Medical Association, or JAMA, contained a sobering warning: Stopping the medication greatly increases the risk of relapsing into depression.
The study authors -- most of them leading psychiatrists at Massachusetts General Hospital, the University of California Los Angeles and Emory University -- said their results challenged a common assumption that hormonal changes during pregnancy protected expectant mothers against depression. In their article, they predicted the findings would prompt some women to stay on their depression medication through pregnancy. That was good news for the makers of big-selling antidepressants, who have recently faced growing questions about the safety of their medications when used during pregnancy.
But the study, and resulting television and newspaper reports of the research, failed to note that most of the 13 authors are paid as consultants or lecturers by the makers of antidepressants. The lead author -- Lee S. Cohen, a Harvard Medical School professor and director of the perinatal and reproductive psychiatry research program at Massachusetts General Hospital -- is a longtime consultant to three antidepressant makers, a paid speaker for seven of them and has his research work funded by four drug makers. None of his financial ties were reported in the study. In total, the authors failed to disclose more than 60 different financial relationships with drug companies.
Dr. Cohen and some of his coauthors subsequently hit the lecture circuit, telling physicians about their findings while also spotlighting flaws in other recent studies that have found increased risks to babies born to mothers who use antidepressants."
AND
"Recently, new concerns have been raised about the safety of antidepressants during pregnancy, mostly among the large class of drugs known as selective serotonin re-uptake inhibitors, or SSRI's. Eli Lilly & Co.'s Prozac, Pfizer Inc.'s Zoloft and GlaxoSmithKline PLC's Paxil are all SSRI's. Some studies have found an increased risk of a potentially fatal breathing disorder and an increased risk of seizures and fetal death among infants born to mothers using a broad spectrum of SSRI's, including these drugs. And two studies have found an increased risk in cardiac malformations in babies born to Paxil users."-2006 Pittsburgh Post Gazette
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Five years after the JAMA study a study comes out discussing the increase of chance of Autism Spectrum Disorders of children born to mothers who took antidepressants while pregnant. In the meantime, one can wonder just how many mothers were in a quandary deciding whether or not to remain on their antidepressant while pregnant, and the JAMA study and paid pharma doctors who were part of it, pushed the 'stay on your meds or suffer a depression relapse' (commonly referred to as 'preventative' medicating).
You're going to have to trust your instinct and gut on that one women, as far as I am concerned, the researchers and tainted influencial KOLs paid by pharma to promote their products and their studies and therefore their profits are scoring 0-0, on the trust scoreboard. It's a crapshoot on who or what to trust, but the bottom line is all drugs and chemical are in your body and bloodstream when you are carrying a child and essentially growing a human body and brain! so be careful, the risk, in my personal opinion outweighs the benefit, especially when reading these studies and the back story on the 2006 JAMA study.
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