Jenni Whalen, Edited by David G. Fairchild, MD, MPH, and Jaye Elizabeth Hefner, MD

Using selective serotonin reuptake inhibitors (SSRIs) during the second or third trimester of pregnancy is associated with a heightened risk for autism spectrum disorder (ASD) in children, according to a JAMA Pediatrics study.

Researchers used data from a population-based cohort study of women from Quebec who delivered

145,000 full-term singleton infants. Children were followed until a mean age of 6.2 years.

Of these, 0.72% were diagnosed with an ASD. Use of any SSRIs during the second or third trimester was associated with increased risk for ASD, compared with no exposure (adjusted hazard ratio, 2.17; 1.4% vs. 0.72%). Use of multiple antidepressant classes in mid-to-late pregnancy was also tied to increased risk. The association between ASD and antidepressants persisted in a subanalysis of women with a history of depression.


NEJM Journal Watch Women’s Health associate editor Allison Bryant comments: “While a small increase in ASD is noted, untreated depression has its own impressive maternal health risks. Research and policy efforts should focus on the provision of comprehensive mental health treatment of pregnant women.”


JAMA Pediatrics article (Free abstract)

JAMA Pediatrics editorial (Subscription required)

Background: NEJM Journal Watch Psychiatry coverage of prenatal antidepressant exposure and autism (Your NEJM Journal Watch registration required)