Taking certain medications prescribed to treat depression, anxiety and other mental-health problems during pregnancy has been linked to a higher risk of autism and developmental delays in male children, according to a study published in Pediatrics.

Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed antidepressants to ease moderate to severe depression, as they cause fewer side effects than other antidepressants do.

However, researchers who used data from the Childhood Autism Risks from Genetics and the Environment study caution that taking the drug during pregnancy is linked to higher incidence of autism spectrum disorder (ASD) and developmental delays (DD) in males.

According to the Centers for Disease Control and Prevention, around 1 in 68 children in the US are diagnosed with ASD, but the disorder is nearly five times more prevalent in boys than girls.

The research team – from the University of California-Davis MIND Institute and led by Prof. Irva Hertz-Picciotto – studied 966 mother-child pairs in total, and the children – between the ages of 2 and 5 – had either ASD, DD or typical development (TD).

The biological mothers were interviewed about prenatal SSRI use, maternal mental health history and sociodemographic information.

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New research suggests a link between SSRI exposure during gestation and increased risk of ASD or DD in male children.

The team found that, among boys, exposure to SSRIs during gestation was nearly three times as likely in children with ASD, compared with TD. Additionally, the strongest association occurred with exposure during the first trimester.

Although the study also included girls, the researchers say the significantly stronger effect seen in boys suggests a potential gender difference in SSRI exposure’s effects.

Li-Ching Lee, study co-author and psychiatric epidemiologist in the Bloomberg School’s Department of Epidemiology, adds that among boys with DD, SSRIs were elevated, “with the strongest exposure effect in the third trimester.”

But the issue of balancing the risks and benefits of taking antidepressants in pregnancy is tricky, as maternal depression carries its own risks to the fetus.

Prof. Hertz-Picciotto says:

This study provides further evidence that in some children, prenatal exposure to SSRIs may influence their risk for developing an autism spectrum disorder.

It also highlights the challenge for women and their physicians, to balance the risks versus benefits from taking these medications, given that a mother’s underlying mental health conditions may also pose a risk to both herself and her child.”

Though their findings are significant, there were certain limitations to the study. For example, the researchers say they had difficulty isolating the effects of the SSRIs from those of their indications for use.

Additionally, the sample of children with DD was relatively small, which yields only rough estimates of association.

Still, the authors say in light of findings on SSRIs and ASD that continue to be inconsistent, their findings suggest “prenatal exposure to SSRIs may increase susceptibility to ASD or DD.”

Recently, Medical News Today reported on a study that suggested the benefits of breastfeeding while on antidepressants outweigh the risks. Researchers from that study say women who stopped taking their antidepressants were more likely to stop breastfeeding; however, breastfeeding has benefits for both mother and child.