A large new review has found that while parental depression is associated with a higher likelihood of autism and ADHD in children, taking antidepressants during pregnancy does not appear to significantly increase that risk once family mental health factors are considered.

Researchers from University of Hong Kong analyzed 37 studies covering more than 25 million pregnancies. Initial data showed that children born to women who used antidepressants during pregnancy were more likely to later receive diagnoses of autism spectrum disorder or attention-deficit/hyperactivity disorder.

However, the association disappeared after researchers adjusted for confounding factors such as family history of neurodevelopmental conditions and parents’ preexisting mental health disorders.

The study also found that children were more likely to be diagnosed with autism or ADHD when fathers used antidepressants during the pregnancy period, even if mothers did not take psychiatric medication. Researchers said this pattern supports the idea that shared genetics and family mental health — rather than medication exposure — may explain the observed link.

The findings were published in The Lancet.

Senior author Wing-Chung Chang said the results support current clinical guidelines, which generally recommend continuing antidepressant treatment during pregnancy when medically necessary.

Scientists noted that concern about antidepressant use during pregnancy intensified after a widely discussed 2015 Canadian study reported a possible association between antidepressant use and autism risk. However, many later studies suggested that maternal depression itself may be the more important factor.

Experts explained that autism and depression frequently occur within the same families and may share underlying genetic and biological pathways. They stressed that untreated depression during pregnancy can also carry serious health risks for both mother and child.

Psychiatrists involved in the discussion said decisions about antidepressant use during pregnancy should carefully balance the potential risks of medication with the dangers of leaving severe depression untreated.