Assessment & Research

In utero exposure to selective serotonin reuptake inhibitors and risk for autism spectrum disorder.

Gidaya et al. (2014) · Journal of autism and developmental disorders 2014
★ The Verdict

SSRI use during pregnancy nudges autism risk up a little, so weigh it against mom’s mental-health needs.

✓ Read this if BCBAs who take developmental histories or counsel expectant mothers.
✗ Skip if Clinicians only working with adults or post-pregnancy interventions.

01Research in Context

01

What this study did

The team pulled birth and pharmacy records for thousands of mother-baby pairs. They asked one question: do moms who filled SSRI prescriptions while pregnant have more kids later diagnosed with autism?

They counted weeks of SSRI use and compared autism rates between exposed and unexposed children.

02

What they found

Kids exposed to SSRIs in the womb had a small but real jump in autism risk. The longer the drug use, the higher the chance.

The numbers stayed tiny—most exposed children did not develop autism—but the link was statistically significant.

03

How this fits with other research

Fahmie et al. (2013) came first. Their narrative review said evidence was “inconclusive” and most studies showed no effect. Danitz et al. (2014) used fresher, bigger registry data and found the small rise, so it updates the earlier wait-and-see view.

Liew et al. (2016) ran a similar registry design with acetaminophen. They also saw a modest ASD bump after long prenatal use. The pattern supports the idea that longer fetal drug exposure, no matter the medicine, can slightly raise autism odds.

Fairthorne et al. (2016) and Chien et al. (2022) show that simply having a maternal psychiatric history, even without drugs, doubles ASD risk. This reminds us that the underlying illness, not just the pill, could share the blame.

04

Why it matters

When families ask about pregnancy history, you can now mention SSRIs as one of many small risk factors. Stress that untreated depression also carries dangers, so the choice needs a doctor. Use the data to encourage balanced, informed decisions rather than blanket fear.

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Add one question about prenatal SSRI duration to your intake form and share the risk numbers without alarm.

02At a glance

Intervention
not applicable
Design
other
Population
autism spectrum disorder
Finding
positive
Magnitude
small

03Original abstract

We investigated whether there is an association between increased risk for autism spectrum disorders (ASD) and selective serotonin reuptake inhibitors (SSRIs) used during pregnancy. This study used Denmark's health and population registers to obtain information regarding prescription drugs, ASD diagnosis, and health and socioeconomic status. There were 1.5 % of cases and 0.7 % of controls exposed to SSRIs during the pregnancy period, and higher effect estimates observed with longer use. We found evidence that in utero exposure to SSRIs increases a child's risk associated with ASD. These results, while adding to the limited knowledge on prenatal pharmacological exposures as potential ASD risk factors, need to be balanced against the benefits of indicated medication use by pregnant mothers.

Journal of autism and developmental disorders, 2014 · doi:10.1007/s10803-014-2128-4