MedicalResearch.com Interview with:
Magdalena Janecka PhD
Department of Psychiatry
Icahn School of Medicine at Mount Sinai
MedicalResearch.com: What is the background for this study?
Response: Our paper explored the association between maternal use of medication during pregnancy and the rates of autism in a large cohort from Israel. This followed on from a number of earlier studies reporting that the use of certain medications – for example antidepressants – during pregnancy is associated with higher rates of autism in children. However, rather than test the effects of any particular drug, or a set of drugs aggregated based on maternal condition, our large dataset allowed us to group all medications prescribed to pregnant women based on their drug target, and in the subsequent analyses focus on over 50 groups that included drugs with neurotransmitter-relevant targets – for example agonists and antagonists of their receptors.
MedicalResearch.com: What are the main findings?
Response: What we found was that in our cohort, majority of those medication groups were not associated with significant changes in the rates of autism, including groups with typical targets of antidepressant and antipsychotic medications. However, we did observe strong associations between estimates of autism risk and maternal health, which is in line with many earlier studies on this topic, and something we definitely want to explore further.
MedicalResearch.com: What should readers take away from your report?
Response: Our paper shows that in our sample, the medications that are commonly used during pregnancy were not associated with higher rates of autism in children. Although such associations have been reported previously, we observed that grouping the drugs by their function, and controlling for a number of maternal factors, robustly diminished such effects. This suggests that maternal health, and conditions for which she takes the medication, may be more important for how the child develops.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: Our findings suggest that maternal health is important not just in terms of the diagnosis for which the medication is prescribed, but also more broadly. For example, even for the groups of medications that consisted mostly of drugs for psychiatric disorders, adjusting for the total number of medical diagnoses that the mother received during pregnancy had stronger effects on our results than adjusting only for those psychiatric issues. This highlights the importance of the wider context of maternal health that needs to be considered in the future.
Janecka M, Kodesh A, Levine SZ, et al. Association of Autism Spectrum Disorder With Prenatal Exposure to Medication Affecting Neurotransmitter Systems. JAMA Psychiatry. Published online October 31, 2018. doi:10.1001/jamapsychiatry.2018.2728
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