Daijiworld Media Network - London
London, May 15: The use of antidepressants during pregnancy does not increase the risk of developmental disorders such as autism or attention deficit hyperactivity disorder (ADHD) in children, according to a large international analysis involving data from more than 25 million pregnancies.
The findings challenge claims made by US Health Secretary Robert F. Kennedy Jr., who has previously alleged without scientific evidence that certain antidepressants could increase autism risk in unborn children.
The study, published in The Lancet Psychiatry, was led by Dr Wing-Chung Chang of the University of Hong Kong.
“Our study provides reassuring evidence that commonly used antidepressants do not increase the risk of neurodevelopmental disorders such as autism and attention deficit hyperactivity disorder in children,” Dr Chang said in a statement.
Researchers analysed data from 37 previous studies involving nearly 650,000 pregnancies where antidepressants were used and almost 25 million pregnancies without antidepressant exposure.
The analysis initially found that children born to mothers who took antidepressants during pregnancy appeared slightly more likely to be diagnosed with autism or ADHD. However, those links became significantly weaker or statistically insignificant after researchers adjusted for factors such as maternal mental health conditions, family history, genetics and other related variables.
Experts said the findings highlighted the importance of separating the effects of underlying mental illness from the impact of medication itself.
“This is a really important point that is easy to get wrong,” said Dr James Walker, professor emeritus of obstetrics and gynaecology at the University of Leeds, who was not involved in the study.
“If you simply compare children whose mothers took antidepressants with children whose mothers did not, you may find a difference. But that does not mean the medicine caused the difference,” he added.
Researchers also observed increased risks of autism and ADHD in children whose fathers used antidepressants while the mothers were pregnant, and among children whose mothers had used antidepressants before pregnancy but not during it.
Scientists said those patterns further suggested that shared family or genetic factors — rather than medication exposure during pregnancy — were more likely to explain the higher risks.
“A father's medication obviously cannot reach the baby in the womb, so this pattern is very hard to explain by anything other than shared family traits,” Walker said.
The study further found that higher doses of antidepressants did not increase the risk of developmental disorders in children, another factor researchers said weakened claims that the medicines themselves were responsible.
Among women with pre-existing mental health disorders, the older antidepressants amitriptyline and nortriptyline were associated with a higher risk of ADHD and autism in children. However, researchers noted that these medicines are generally prescribed only when depression is more severe or resistant to treatment.
The drugs belong to a class known as tricyclic antidepressants and are different from selective serotonin reuptake inhibitors (SSRIs), the widely used antidepressants most frequently criticised by Kennedy.
Researchers said pregnant women with mild depression may benefit from non-drug treatments such as psychotherapy, but warned against abruptly stopping antidepressant medication during pregnancy.
“Antidepressants should never be withheld during pregnancy solely because of inconsistent and potentially confounded reports of neurodevelopmental risk,” the researchers said.
They warned that sudden discontinuation of treatment could worsen maternal depression, which itself is linked to negative outcomes for both mothers and children.
Dr Anita Banerjee, an obstetrician at King’s College London who was not involved in the study, said untreated maternal mental illness carried serious risks.
She noted that mental health disorders remain the leading cause of maternal mortality in the year following childbirth in the United Kingdom.