To the Editor Boukhris et al1 have reported their findings from a population-based study stating that antidepressant use among pregnant mothers, specifically selective serotonin reuptake inhibitors, increases the risk for autism spectrum disorders in offspring. This finding considered maternal history of depression in the analysis, suggesting underlying interactions that contribute to a maternal depressive phenotype may explain the higher autism spectrum disorder offspring risk. Shelton et al2 described an increased risk of autism spectrum disorder in offspring among mothers living near agricultural areas with exposure to various chemicals and pollutants. It is possible that the increased risk from such exposures may be direct, or these pesticides may be confounding other undocumented exposures that are associated with the use of these pesticides.
Fluegge K. Prenatal Antidepressant Use and Risk of Autism Spectrum Disorders in Children. JAMA Pediatr. 2016;170(7):710. doi:10.1001/jamapediatrics.2016.0739