The effect of antidepressants during pregnancy on the incidence of autism in children

Abstract

Overview of the topic: In this dissertation the effect of antidepressants during pregnancy on the incidence of autism in children is studied. Autism is part of the autism spectrum disorder which can be described as a neurodevelopmental disorder. It usually presents symptoms in the first year of life hence it is important that the children cohort is used in the study. Furthermore, the effect of antidepressants is studied due to the fact that antidepressant use is relatively high both internationally and in Malta. In fact 60% of the Maltese population take antidepressants. with both antidepressant use and autism on the rise the issue is studied with the aim of reducing the incidence of autism. The research question: Do antidepressants during pregnancy lead to autism in children? PEO elements: The population (P) studied was pregnant women. The Exposure (E) observed was antidepressants and the expected outcome (O) was Autism in children. Method: the elements of the PEO question, along with alternative terms were combined using Boolean operators. Limiters were applied in order to refine the search results. Both EBSCO databases and PubMed were accessed to conduct the searches. In order to exclude irrelevant articles, the PRISMA checklist was also used. Inclusion and exclusion criteria (table 2.) were applied to the articles retrieved to asses the eligibility of results. Finally, the Critical Appraisal Skills Programme (CASP) tool was used to critically appraise the articles. Results: A total of 5 studies were selected. These include 2 cohort studies, 2 meta- analysis and 1 systematic review. All the studies produced different results. 3 studies found a positive association between antidepressants and autism while 2 found no associations. Reasons for decrease in the risk of autism was mostly due to maternal psychiatric disorders. Conclusion: A final conclusion cannot be reached based on the results. However, there are strong indications that the relation could be due to unmeasured confounding. Because of this, more research needs to be done in the field to resolve the unanswered questions. Implications and recommendations: There are strong indications that it is not beneficial to stop antidepressants based on the risk of the child developing Autism due to the implications of untreated depression. Mothers should make an informed decision based on all the information present at the time of pregnancy that benefits both baby and mother.