Category Archives: Autism

Antidepressant Link with Preterm Birth and Autism

According to research published online ahead of print in March 2014, women who take antidepressants during pregnancy are more likely to deliver their babies prematurely than women who don’t take them.

Increased fourfold

Lead author of the study Krista Huybrechts, MS PhD from the Division of Pharmacoepidemiology and Pharmacoeconomics at Brigham and Women’s Hospital and Harvard Medical School said the number of women using antidepressants whilst pregnant has increased over the past twenty years.


“Preterm birth is a major clinical problem throughout the world and rates have been increasing over the past two decades. At the same time, rates of antidepressant use during pregnancy have increased approximately four-fold,” said Dr Huybrechts.

41 papers studied

According to senior Author Dr Adam Urato, they found a link between antidepressants and preterm birth.

“We studied 41 papers on this topic and found that the available scientific evidence is becoming clearer that antidepressant use in pregnancy is associated with preterm birth”.

Could depression be the culprit?

Apparently not!

“The complication of preterm birth does not appear to be due to the maternal depression, but rather it appears likely to be a medication effect” said Dr Urato.

SSRIs and autism link

A study by John Hopkins Bloomberg School of Public Health revealed that when antidepressants called SSRIs are taken during pregnancy, there is a higher risk of autism and developmental delays.

SSRI’s or Selective Serotonin Reuptake Inhibitors work by increasing the levels of Serotonin (a feel good hormone) in the brain by inhibiting the mechanisms that naturally absorbs serotonin.

The autism link, which was published in the online Journal Pediatrics, involved researchers looking at almost 1,000 children, most of them boys, who had Autism and developmental delays and also children with typical development.

Boys affected more

 The researchers found gender differences in the effect of prenatal exposure to anti depressants with boys being more likely to be affected than girls.

“We found prenatal SSRI exposure was almost three times as likely in boys with autism spectrum disorders relative to typical development, with the greatest risk when exposure is during the first trimester,” said study co-author Li-Ching Lee, an associate scientist in the department of epidemiology at Johns Hopkins Bloomberg School of Public Health, in Baltimore.

Should women stop taking their meds?

No, say some experts, as the risks are low and it’s important to treat depression in pregnant women. Others aren’t so sure. Although medication may be the only option for severe depression, other safer alternatives may be a better option for milder cases.

What about whilst breastfeeding?

Research presented at the 18th Perinatal Society of Australia and New Zealand annual conference in Perth, explained that women are more likely to continue breastfeeding if they continue taking their antidepressants.

Research carried out by Adelaide University found that 67 percent of women stopped taking antidepressants before becoming pregnant or when they started to breastfeed. The remaining 33 percent continued to take their antidepressant medication throughout pregnancy and while breastfeeding and they breastfed for longer.

“These women were much more successful at maintaining breastfeeding up to and beyond the recommended 6 months” explained Dr Luke Grzeskowiak who led the research.

Dr Grzeskowiak and his colleagues maintain that women should be supported and encouraged by health care providers, as well as family and friends to continue with their medication.

Conflicting information

Unfortunately there isn’t an exact science to weigh up the benefits of taking antidepressant medication during pregnancy and whilst breastfeeding, against the risks to the baby.  Of the numerous studies carried out, many carry conflicting results leaving women and even some doctors unsure of whether medication is really safe.

According to a research study by Filomina Fortinguerra et al and published in Pediatrics in October 2009, the main concern about taking SSRIs whilst breastfeeding, is whether long term exposure may have long term neurobehavioural effects as most of the studies carried out so far have been short term studies.

This research report also said that Fluoxetine (Prozac) was contraindicated whilst breastfeeding. However, another research study by Professor Louis Appleby et al and published in the British Medical Journal found Prozac to be an effective treatment for women with Post Natal Depression.

Just to confuse the matter even more, NICE (National Institute for Health and Care Excellence) advises that Prozac is not recommended whilst breasting unless a woman has already been taking it without any problems during pregnancy.

Best for baby

The most important thing for anyone suffering from depression or considering medication options whilst pregnant or breastfeeding is to discuss their case and all their symptoms with a qualified health care provider. Some women with severe depression will almost certainly need to take medication to keep their depression under control and in these cases this would be in the best interests of the baby too.

However, for many, particularly those with mild depression, it may be that with support and possibly alternative treatments like psychotherapy or natural remedies that the depression is completely manageable without antidepressants and this would be ideally be the best option for baby.

Could a 1 minute video, screen young kids for autism?

A new study carried out by the National Institute for Mental Health (NIMH) has identified what could be a simple and inexpensive screening tool for detecting autism in young children.

Dr Karen Pierce from the University Of California San Diego School Of Medicine and her colleagues showed a group of young children a 1 minute video showing geometric patterns in the form of a computer screen saver on one side of a monitor, and a clip of children involved in social movement (yoga and dancing) on the other side.

The aim was to find out whether very young children with an Autistic Spectrum Disorder (ASD) focussed more on the geometric patterns or on social movement, and whether an ASD could be predicted.

The study, which has been published in the September 6th Edition of the Archives of General Psychiatry, involved 110 young children between the ages of 14 and 42 months.

Of these children, 37 had an autistic spectrum disorder (ASD) and 22 were classed as developmentally delayed (DD) but did not actually have an ASD. The remaining children were free from autism and had a typical development (TD).

What the researchers found was that 40 percent of the children with ASD spent more time focussing on the geometric patterns than on social movement. Almost 10 percent of the DD kids focussed on the patterns more and just less than 2 percent of the kids with a typical development.

They also found that if a child spent more than 69 percent of the time focussing on the geometric patterns, an Autistic Spectrum Disorder could be predicted 100 percent of the time.

Eye tracking equipment was used to follow the line of gaze of the children and although the children did switch their gaze from one side to the other, those with ASD showed less eye movement when looking at the patterns and showed more frequent eye movement than the other kids when looking at the images children in the social video.

A follow up of 41 of the kids which took place 8 months later showed that the way they originally viewed the videos hadn’t really changed.

The results indicate that a preference for geometric patterns over social movement and how long they gazed at the geometric patterns could offer an inexpensive and easily used screening tool for ASD.

The study concluded that “a preference for geometric patterns early in life may be a novel and easily detectable early signature of infants and toddlers at risk for autism”.