WeeklySA_AdminDATA: Analysis of over six million births reveals a troubling association between widely prescribed drugs and increased autism risk, prompting calls for urgent review of treatment during pregnancy…
By Own Correspondent
A landmark US study analysing more than six million birth records has uncovered a significant link between commonly prescribed medications during pregnancy and an increased risk of autism spectrum disorder (ASD) in children.
The research, led by scientists at the University of Nebraska Medical Centre and published in Molecular Psychiatry, examined 6.14 million maternal-child health records from the Epic Cosmos database, covering nearly a third of all births in the United States between 2014 and 2023.
Instead of grouping drugs by their intended use, researchers classified medications according to their impact on the body’s cholesterol production pathway, known as sterol biosynthesis—critical for fetal brain development.
They found that exposure during pregnancy to sterol biosynthesis–inhibiting medications (SBIMs) was consistently associated with higher rates of ASD in offspring.
These medications include widely used treatments such as certain antidepressants, antipsychotics, anti-anxiety drugs, beta-blockers and statins—among them aripiprazole, fluoxetine, sertraline, propranolol and atorvastatin.
Risk patterns
The study identified a clear pattern of increased risk:
Mothers prescribed at least one SBIM during pregnancy had a 1.47 times higher likelihood of having a child diagnosed with ASD.
The risk rose with multiple prescriptions, reaching 2.33 times higher when four or more such drugs were used simultaneously.
Of the 196,447 children diagnosed with ASD in the dataset, 14.2% had prenatal exposure to these medications.
Use of these drugs during pregnancy has also surged, rising from 4.3% of pregnancies in 2014 to 16.8% in 2023.
Why cholesterol matters
Cholesterol plays a vital role in fetal development, particularly in the brain – the body’s most cholesterol-rich organ. The fetal brain begins producing its own sterols around the midpoint of pregnancy.
Disruptions to this process are already known to cause severe developmental disorders such as Smith-Lemli-Opitz syndrome, where up to 75% of affected children meet criteria for ASD.
Researchers say many commonly prescribed medications may unintentionally interfere with this pathway, raising concerns about their use during pregnancy.
Call for caution
Lead researcher Professor Karoly Mirnics emphasised that the findings should not trigger alarm but rather careful reassessment.
“Our findings do not suggest that these medications are unsafe for adults,” he said. “But they raise important questions about their use during pregnancy, when even small biochemical disruptions may have outsized effects on fetal brain development.”
Crucially, researchers warn that pregnant women should not stop or change medication without medical supervision, as many of these treatments are essential and, in some cases, life-saving.
A public health signal
Instead, the study highlights the need for improved prescribing practices and further investigation into safer alternatives.
Among the proposed next steps:
Developing a comprehensive list of medications that affect sterol biosynthesis;
Screening new drugs for unintended impact on cholesterol pathways; Increasing awareness among healthcare providers;
Reducing multiple drug exposure during pregnancy where possible; and Identifying patients with genetic vulnerabilities to sterol disruption.
The researchers describe the findings as a “public health signal”—one that warrants urgent attention but careful interpretation.
According to the World Health Organization, about 1 in every 100 children globally has autism. In South Africa, the local studies have found the prevalence of autism to be between 0.08% to 2%. This condition is mainly found to be more prevalent in males than females.
Autism can be a life-long condition, but through appropriate and tailored support, children and adults with autism can make significant progress and live fulfilling lives.
As global autism diagnoses continue to rise, the study adds a new layer to the complex puzzle of environmental and biological risk factors—placing medication safety during pregnancy firmly under the spotlight. – Newswise
Our findings do not suggest that these medications are unsafe for adults. But they raise important questions about their use during pregnancy,
when even small biochemical disruptions may have outsized effects on fetal brain development…
