The use of antidepressants during pregnancy is controversial at best. In the past, studies have indicated that using these kinds of prescription drugs during pregnancy can increase the risk of autism, cognitive deficits and other health issues — but other studies have also concluded that antidepressants pose no additional risk. Overall, the general consensus seems to have remained at an impasse, with some scientists recommending that ultimately, the potential risks must be weighed against potential benefits for expecting mothers.
However, a recent press release from the Journal of the American Medical Association (JAMA) claims that there is no increased risk of autism or ADHD when antidepressants are used in pregnancy, even though the findings were not truly conclusive. Two studies were featured in the release. The Canadian researchers of the first study wrote, “Although a causal relationship cannot be ruled out, the previously observed association may be explained by other factors.”
In the study, the researchers found that children who were exposed to serotonergic antidepressants while in the womb were more likely to develop autism at a statistically significant rate. However, after adjusting for “confounding” factors, which were not described in the JAMA release, this increased risk seemed to disappear. Combined with their statement, it’s clear that these findings are far from definitive: As the researchers themselves state, a casual relationship (or even a more direct association) may exist. It is quite possible that the “confounding factors” the researchers adjusted for are merely obscuring that relationship.
The second study JAMA reported relied on self-reported antidepressant use during the first trimester — and as we all know, there are three trimesters in pregnancy.
A baby’s brain is not fully developed at the end of the first trimester — not even close. While the major parts of the brain are formed, it will continue to develop and transform during the pregnancy. As Modern Mom explains, it is during the second and third trimesters that a developing baby’s brain begins to connect with other organs, as synapses form and grow. Brain development is still occurring even at the eighth month of pregnancy. So, why would the researchers only look at the first trimester, when it is completely possible for changes in brain development to occur later during pregnancy?
In fact, in 2014, NBC News reported on a study that suggested the brain changes related to the onset of autism occur during the later stages of pregnancy. Eric Courchesne of the University of California, San Diego’s Autism Center of Excellence reportedly said of the findings: “It supports the idea that the changes that cause autism are happening in the second and third trimester of pregnancy.”
And yet, the researchers from the second study reported on by JAMA chose to only look at first-trimester antidepressant use.
Daily Mail also recently reported on a different study (that was also published in JAMA) showed that the offspring of moms-to-be who took antidepressants during pregnancy were 81 percent more likely to be on the autism spectrum. The researchers also found that women who took antidepressants before conceiving a child were 77 percent more likely to give birth to a child with autism. According to Daily Mail, “The findings are concerning given the increasing usage of the medications during pregnancy, experts say.”
While the French researchers tempered their findings by stating that ceasing antidepressant usage could come with more consequences than continuing to take them, the fact remains that the risk is there, especially as the number of expecting mothers taking antidepressant medications continues to increase. After analyzing data from two other studies, the researchers noted that the increased risk no longer seemed to be present. (RELATED: Learn more about the dangerous effects of prescription drugs at DangerousMedicine.com)
Measuring the risks imposed by any drug during pregnancy is decidedly difficult, due to the presence of confounding factors like maternal illness. Interestingly enough, the reverse of this is also true: Confounding factors like maternal illness could also potentially mask any harmful effects that are caused by these confounding factors.
Is it really possible to measure the true impact antidepressants may have on developing fetuses? Only time will tell.