Exposição a antidepressivos durante a gestação e desenvolvimento de transtorno do espectro autista: uma revisão narrativa de literatura

Antidepressant exposure during pregnancy, particularly exposure to selective serotonin reuptake inhibitors (SSRIs), has been investigated for its possible association with the development of autism spectrum disorder (ASD) in offspring. This narrative review aimed to discuss the scientific evidence on this association, considering potential biological mechanisms, the influence of confounding factors and clinical implications. A literature search was initially conducted in PubMed and supplemented with relevant publications, including observational studies, systematic reviews and meta-analyses. Some studies identified an association between antidepressant exposure during pregnancy and ASD diagnosis, whereas others found that this association was attenuated or no longer statistically significant after adjustment for maternal psychiatric disorders and familial factors. These differences highlight the difficulty of distinguishing the potential effects of medication from those related to maternal psychiatric conditions and shared family characteristics. Although the role of serotonin in neurodevelopment provides a biological basis for investigating the potential effects of SSRIs, the available evidence does not establish an independent causal relationship between their use during pregnancy and the development of ASD. In conclusion, decisions regarding the use of these medicines should consider both the potential risks of foetal exposure and the consequences of untreated maternal depression and anxiety disorders, through an individualised assessment of the risks and benefits of treatment.