(Abstracted from BMJ 2017;358:j2811)
Although several recent epidemiological studies have assessed the relation between antidepressant use during pregnancy and autism in offspring, robust conclusions have been elusive because of concerns about “confounding by indication.” That is, because depression or other psychiatric indications for antidepressant use could be associated with autism through genetic or nongenetic pathways, it was not possible to rule out the possibility of the observed associations representing the risk of autism from the underlying indication for prescription. The authors undertook the present study in order to improve the understanding of the association between antidepressant use during pregnancy and autism in offspring, by applying a range of causal analytical methods on data from a large total population cohort in Stockholm County, Sweden.
Centre for Academic Mental Health, School of Social and Community Medicine, University of Bristol (D.R.); Avon and Wiltshire Partnership NHS Mental Health Trust (D.R.), Bristol, United Kingdom; Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden (D.R., B.K.L., C.D., C.M.); NIHR Biomedical Research Centre, University of Bristol, Bristol, United Kingdom (D.R.); Drexel University School of Public Health (B.K.L., C.N.) and AJ Drexel Autism Institute (B.K.L., C.N.), Philadelphia, PA; Centre for Epidemiology and Community Medicine, Stockholm Health Care Services, Stockholm, Sweden (C.D., C.M.); and Division of Psychiatry, University College London, London, United Kingdon (G.L.)