Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Jan 10:5:1.
doi: 10.1186/s40748-018-0096-y. eCollection 2019.

Association between antidepressant use during pregnancy and autism spectrum disorder in children: a retrospective cohort study based on Japanese claims data

Madoka Yamamoto-Sasaki  1 , Satomi Yoshida  1 , Masato Takeuchi  1 , Sachiko Tanaka-Mizuno  2 , Yusuke Ogawa  3 , Toshiaki A Furukawa  4 , Koji Kawakami  1
Affiliations

Association between antidepressant use during pregnancy and autism spectrum disorder in children: a retrospective cohort study based on Japanese claims data

Madoka Yamamoto-Sasaki et al. Matern Health Neonatol Perinatol. .

Abstract

Background: Studies using data from Western countries have raised concerns that treating pregnant women with antidepressants may increase the risk of autism spectrum disorders (ASDs) in their offspring. However, to date, the studies are inconclusive. We therefore examined the association between antidepressant use and ASD using claims data collected in Japan.

Methods: This retrospective cohort study was based on claims data from mothers and their children from January 2005 to July 2014, obtained from the Japan Medical Data Center. The information from mothers and children was linked using the family identification code. Information on antidepressant prescriptions during pregnancy was extracted from the database. To collect information on ASD, children for whom data were available 24 months or more after birth were followed up from birth through July 2014 or up until their withdrawal from the database. To ensure appropriate diagnosis of ASD, mother-child pairs where the children's data did not cover the 24 months after birth or pairs where children had a diagnosis of ASD within only 23 months after birth were excluded from the study cohort. We used logistic regression analyses to evaluate the association between antidepressant use during pregnancy and the children's ASD diagnosis. All statistical analyses were performed using IBM SPSS (Statistical Package for the Social Sciences) Statistics ver. 21.0.

Results: Of the 53,864 eligible mother-child pairs, 26,925 met the study criteria. Crude analysis showed that the ASD prevalence in children was significantly higher with any antidepressant use than with non-use (odds ratio [OR], 2.32; 95% confidence interval [CI], 1.08, 4.95). However, when the analysis was adjusted for the confounding effect of maternal depression during pregnancy, statistical significance was lost (OR, 0.76; CI, 0.27, 2.18).

Conclusions: After adjustment for confounders, we found no significant association between antidepressant use during pregnancy and ASD in children in Japan. This result provides additional evidence to support the idea that antidepressant use during pregnancy itself is not associated with an increase in ASD in children. In addition, this represents the first evidence based on Asian data.

Keywords: Antidepressant; Autism spectrum disorder; Maternal depression; Pregnancy.

PubMed Disclaimer

Conflict of interest statement

Our study protocol was approved by the Kyoto University Graduate School and Faculty of Medicine, Ethics Committee. For this type of study, formal consent is not required.Not applicable.All of the authors except one report they have no conflict of interest to disclose. KK receives consulting fees or speakers honoraria from: Takeda Pharmaceutical Co., Ltd., Kaken Pharmaceutical Co., Ltd., AbbVie Inc., Eisai Co., Ltd., Daiichi Sankyo Co., Ltd., Santen Pharmaceutical Co., Ltd., Bayer Yakuhin Ltd., Chugai Pharmaceutical Co., Ltd., Otsuka Pharmaceutical Co., Ltd., Olympus Corporation, Shin Nippon Biomedical Laboratories, LTD., and Japan Medical Data Center Co., Ltd.; research funds from: Olympus Corporation, Sumitomo Dainippon Pharma Co., Ltd., Bayer Yakuhin Ltd., Stella Pharma Corporation, Novartis Pharma K.K., CMIC Co., Ltd., Amgen Astellas BioPharma K.K., Suntory Beverage & Food Ltd., and Medical Platform Co., Ltd.; and holds stocks in: School Health Record Center Co., Ltd. and Real World Data Co., Ltd.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Flowchart of the process of identifying mother-child pairs for inclusion in the study. Abbreviations: ASD, autism spectrum disorder
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Le Strat Y, Dubertret C, Le Foll B. Prevalence and correlates of major depression episode in pregnant and postpartum women in the United States. J Affect Disord. 2011;135:128–138. doi: 10.1016/j.jad.2011.07.004. - DOI - PubMed
    1. Gentile S. Untreated depression during pregnancy: short- and long-term effects in offspring: a systematic review. Neuroscience. 2017;342:154–166. doi: 10.1016/j.neuroscience.2015.09.001. - DOI - PubMed
    1. Stein A, Pearson RM, Goodman SH, Rapa E, Rahman A, McCallum M, et al. Effects of perinatal mental disorders on the fetus and child. Lancet. 2014;384:1800–1819. doi: 10.1016/S0140-6736(14)61277-0. - DOI - PubMed
    1. Molenaar NM, Brouwer ME, Duvekot JJ, Burger H, Knijff EM, Hoogendijk WJ, et al. Antidepressants during pregnancy: guideline adherence and current practice amongst Dutch gynaecologists and midwives. Midwifery. 2018;61:29–35. doi: 10.1016/j.midw.2018.02.018. - DOI - PubMed
    1. Yonkers KA, Blackwell KA, Glover J, Forray A. Antidepressant use in pregnant and postpartum women. Annu Rev Clin Psychol. 2014;10:369–392. doi: 10.1146/annurev-clinpsy-032813-153626. - DOI - PMC - PubMed

LinkOut - more resources