So of course, dozens of studies have attempted to parse whether antidepressants are safe during pregnancy. Their results are inconclusive, which is probably not reassuring to expectant mothers. Into this situation comes a new study from Canada that finds expectant mothers who take antidepressants are more likely to give birth to children who end up diagnosis with spectrum disorder. That may sound worrisome, but the effect here is quite small. "It shouldn’t be alarming people," says Alan Brown, a psychiatrist at Columbia who is not involved with the study. The relative risk for autism went up 87 percent when women took antidepressants during their second or third trimester. But for context, the rate of autism is around 1 percent, so it could go up to 1.87 percent with antidepressants. Add another wrinkle: Untreated depression is bad for baby, too. "Depression is a serious disease," says Bryan King, a psychiatrist at Seattle Children’s Hospital, who wrote an editorial in JAMA Pediatrics accompanying the study. "Untreated depression is associated with lack of nutrition or lack of sleep or fatigue and stress, which we know can cause problems in terms of fetal development." The fact that several previous studies on autism and antidepressant use during pregnancy have come up mixed, and the small effect size in this most recent one, says King, should reassure mothers with severe depression who choose to continue their regimen.
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