Antidepressant Use During Pregnancy May Raise Autism Risk? A new study!

It is very common for mothers to be taking anti-depressant medication before, during or after a pregnancy. Women with depression who are pregnant or hoping to get pregnant may be alarmed at new research that points to a link between the use of selective serotonin reuptake inhibitors (SSRIs), a type of antidepressant, and the occurrence of autism in unborn kids.

In the study, published in the journal Archives of General Psychiatry, researchers led by Lisa Croen of Kaiser Permanente Northern California reviewed the medical records of more than 1,600 children, 298 of whom had autism spectrum disorders (ASDs). Essentially the study stated that children whose mothers take Zoloft, Prozac, Paxil, Celexa or similar antidepressants during pregnancy are twice as likely as other children to have a diagnosis of autism or a related disorder. This study is the first to examine the relationship between antidepressants and autism risk within children. But is this study too early to draw direct links? Or is it a step forward in understanding the links to autism and children?

The study, which was published Monday in the Archives of General Psychiatry, is a small initial investigation into what is likely to become a better-studied area of what causes children to develop the group of developmental and cognitive problems known as Autism Spectrum Disorder.

In my opinion, there are important limitations to the study, and the clinical implications are not entirely clear. In the general population, the researchers wrote, “the fraction of cases of ASD that may be attributed to use of antidepressants by the mother during pregnancy is less than 3 percent…and it is reasonable to conclude that prenatal SSRI exposure is very unlikely to be a  major risk factor for ASD.” However, while they urged caution in interpreting the results, they said they believe the results do suggest a modest link between SSRIs and autism.

“Poor maternal mental health during pregnancy is a major public health issue,” Tim Oberlander, M.D., a professor of developmental pediatrics at the University of British Columbia, in Vancouver, told CNN.com. “Nontreatment is not an option.  While some children might be at risk from an SSRI exposure–and we don’t know who, and how that works–there are many mothers and their children as well who will benefit.”

According to the Archives of General Psychiatry, classes of antidepressants, known as  selective serotonin reuptake inhibitors (SSRIs), may be especially risky early on in a pregnancy. Children who were exposed to the drugs during the first trimester were nearly four times as likely to develop an autism spectrum disorder (ASD) compared with unexposed children, according to the study.

Only 20 of the almost 300 children studied had been exposed to antidepressants in utero, so researchers urged further investigation and study.

Important Note: The study included fewer than 300 children with a diagnosed ASD and does not prove that taking SSRIs during pregnancy directly causes ASDs, which affect approximately 1 percent of children in the U.S. The findings will need to be confirmed in larger studies, and should not dissuade women from starting or continuing to take SSRIs, experts on prenatal drug exposure and mental health say.

I think that it is possible that a very intricate and well-designed study could reveal an even larger association between the use of antidepressants and ASD. Preliminary studies such as this recent one are very influential in research, because they open the door to new ideas and provide a stage for new studies that could provide much better solutions on this issue.

I question — where does this leave women who are pregnant and suffering from depression? I think that those women suffering should seek out help from their doctors and use their judgment in trying to balance the importance of treating depression, while understanding the possibility that using antidepressants could, in some cases, contribute to risk for ASD. All in all? The current research does not provide a definitive answer….but who knows in the future!

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Mouthwash as a preventative for pre-mature births?

I was surfing the internet yesterday and read about a very interesting new study about pre-mature births and how something as simple as swishing your teeth with mouthwash can help prevent pre-mature births and cut the risk of giving birth to low birth-weight babies. I found this very intriguing and thought I would share it with you…when I first read the article, I thought it was an old wives tale, but the study seems to have some very interesting and relevant evidence to back up this new belief.

The study, presented at the Society for Maternal-Fetal Medicine’s annual meeting, suggests that mothers at high risk for an early birth can cut the risk by about 2/3 simply by using of an alcohol-free antibacterial mouthwash.

Lead author of the study, Dr. Marjorie Jeffcoat, a professor of periodontics at the University of Pennsylvania stated, “Preterm birth is the major cause of perinatal mortality and morbidity worldwide and still difficult to predict and prevent. So, when we found that something as simple as mouthwash could change the outcomes, we were very excited.”

A scary fact is that each year, about 13 million babies around the world are born prematurely, leading to death in some, cerebral palsy, intellectual disabilities, and breathing an developmental difficulties in others.

What is the cause of pre-mature births?
A number of factors can increase the risk of preterm birth, such as a mother’s low weight, smoking and drug abuse, but oral infections can also raise the risk.

The Study:
Researchers enrolled 204 pregnant women at 6-20 weeks gestation. All of them had periodontal disease which can cause the gums and the bone around the teeth to decay. None of them were receiving dental care. A group of 49 women were given a antimicrobial, alcohol-free mouthwash containing cetyl pyridinium chloride (CPC), to be used twice daily.

The rates of preterm birth were two thirds lower in this group than in the control group of 155 women.

The Studies Findings:

• It was noted that only 6.1 percent of the women who used a mouthwash had a premature delivery as opposed to 21.9 percent of those who did not use the rinse.
• Even after factoring age, smoking, and alcohol consumption, women adopting oral hygiene exhibited a two-third reduction in premature deliveries.
• Only 6.1 percent of the mouthwash using women had premature deliveries, compared to 21.9 percent of those who didn’t rinse.

Jeffcoat stated, “These results were so dramatic. There is a public health responsibility, in fact, to know what we found, to repeat it, to find out who should get it.”

So what’s the overall importance? Pregnant women have an extra susceptibility to bacterial infections– if the gums become severely affected, the infection could possibly trigger labor. This study also adds to evidence that dental care in pregnancy is very important! So brush and floss those pearly whites! 🙂

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