30795
Maternal Perinatal Depression and Risk of Autism: Preliminary DATA of a Longitudinal Evaluation in Offspring
Autism Spectrum Disorder (ASD) is the final consequence of cascade events impacting brain development from gestation to early post-natal life. The high prevalence of maternal perinatal depression (PD) within pregnant women (10-25%), the steadily increasing use of psychotropic medications during pregnancy and the potential long-term effects on offspring neurodevelopment and behavior gives this topic public health importance. Studies investigating possible associations between maternal PD and higher risk of ASD show inconclusive and contrasting results. This controversy highlights the need of longitudinal and well structured studies evaluating the ASD risk in offspring of perinatal depressed women.
Objectives:
Primary aim of the study was to longitudinally evaluate possible long-term effects of maternal PD on socio-communicative and behavioral phenotype of the offspring with a specific focus on the increase of ASD risk. Secondary objective was to characterize the clinical phenotype of: Offspring of Perinatal Depressed women pharmacologically Treated during pregnancy (OPD-T) compared to offspring not exposed to drug treatment (OPD-NT).
Methods:
A total of 30 mother-child pairs were enrolled in the study. Psychiatric clinical evaluation of the women was performed during the 2nd trimester of pregnancy (Edinburgh Perinatal Depression Scale-EPDS, State Trait Inventory for Cognitive and Somatic Anxiety – TRAIT, STICSA T). Standardized clinical assessment of the children at a mean age of 5 years was performed in order to measure the presence of: autistic symptoms (Autism Diagnostic Observation Schedule-ADOS-2; Social Responsiveness Scale-SRS) and behavioural features (Conners’ Parents).
Results:
We report preliminary results on: 16 women (mean age 37 years) and their 16 children (mean age 5 years) (Figure1). In the group of women affected by PD, two children received diagnosis of autism, while in the group of healthy control women (HC), only one child was affected by ASD. No significant statistical difference emerged, between the offspring of women affected by PD (O-PD) and the children of HC women (O-HC), in the level of autistic symptoms and socio-communicative difficulties, measured by ADOS total score (mean: 4,00 O-PD vs 3,00 O-HC), ADOS calibrated severity score CSS (mean: 2,11 O-PD vs 2,20 O-HC), SRS total score (mean: 58,50 O-PD vs 52,60 O-HC), However, children of PD mothers not pharmacologically treated in pregnancy (OPD-NT) scored higher compared to offspring of pharmacologically treated women (OPD-T) on: ADOS total (mean: 6,00 OPD-NT vs 2,86 OPD-T), CSS (mean: 3,67 OPD-NT vs 1,33 OPD-T), SRS total (mean: 64,00 OPD-NT vs 56,14 OPD-T), Defiant (mean: 53,67 OPD-NT vs 46,71 OPD-T) Hyperkinetic behaviours (mean: 63,33 OPD-NT vs 52,00 OPD-T) and Inattention score of Conners’ (mean: 68,00 OPD-NT vs 48,57 OPD-T).
Conclusions:
Our preliminary results don’t show a significant increased risk of autism in the children of women affected by perinatal depression compared to offspring of healthy control mothers. However, a different clinical phenotype came out within the offspring of women affected by perinatal depression and exposed to psychotropic medications during pregnancy compared to offspring not prenatally exposed to pharmacotherapy. Specifically, lower sub-threshold autistic symptoms and less defiant-inattentive-hyperkinetic behaviours emerged within offspring exposed to psychotropic medications in pre-natal period.