Implications of prenatal exposure to selective serotonin reuptake inhibitors for autism spectrum disorders
Katarzyna Krajewska1, Angelika Słowińska2

Autism spectrum disorder is a group of neurodevelopmental disorders characterised by deficits in social relations, impairments in communication, and restricted, repetitive behaviours and interests. The aetiology of autism is unclear, but studies suggest interaction of genetic and environmental factors leading to disturbances in neurotransmission and anatomical development of the brain. Serotonin, a neurotransmitter in the central nervous system and autacoid in the periphery, has long been of interest in autism spectrum disorders. Repeated, independent findings of increased platelet serotonin levels in approximately one third of children with autism suggest that dysfunction of serotonergic system may play a causal role in the physiopathology of these disorders. Because of the critical role of serotonin in foetal brain development and function, several research groups have focused on the influence of prenatal exposure to substances that manipulate serotonin levels like selective serotonin reuptake inhibitors. They are the most commonly prescribed antidepressant medications worldwide, with studies indicating that 2–13% of pregnant women in developed countries receive antidepressant medication. A suggested (but still controversial) association between the exposure to selective serotonin reuptake inhibitors during pregnancy and the prevalence of autism spectrum disorders may be confounded by the indications for which these drugs are prescribed such as maternal depression. This review examines evidence regarding the association between prenatal exposure to selective serotonin reuptake inhibitors and autism spectrum disorders.