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Major Review Finds Little Evidence Antidepressants in Pregnancy Raise Autism or ADHD Risk

The results support guidance to continue needed treatment in pregnancy to reduce harm from untreated depression.

Overview

  • The meta-analysis, published Thursday, found initial links to autism and ADHD weakened to little or no association after accounting for parental mental health and other confounders.
  • Researchers pooled 37 studies covering about 648,000 exposed pregnancies and nearly 25 million unexposed, and they used sibling, paternal, and preconception comparisons to test causality.
  • Only the older tricyclic drugs amitriptyline and nortriptyline showed higher risks in some analyses when confounding was minimized, and the authors said causation remains unclear.
  • Clinicians and authors advised continuing antidepressants for moderate to severe depression in pregnancy because untreated illness raises risks like prematurity, low birth weight, and maternal death.
  • The findings push back on recent claims by HHS Secretary Robert F. Kennedy Jr., yet the authors noted wide study differences and gaps in data on socioeconomic factors, dosing, and timing that warrant further research.