A quarterly publication of the Autism Research Institute
Spring 2026 | Number 2, Volume 40
An analysis of millions of maternal-child health records by U.S. researchers suggests that taking one particular type of medication during pregnancy can raise the odds of having a child with an autism spectrum disorder (ASD).
Eric Peeples and colleagues investigated medications that inhibit the cholesterolsynthesis pathway (sterol biosynthesis-inhibiting medications, or SBIMs). These include certain antidepressants, antipsychotics, statins, beta-blockers, and anti-anxiety medications.
To evaluate the effects of these drugs, the researchers analyzed 6.14 million maternal child health records from the Epic Cosmos database. The researchers found that moth ers prescribed at least one SBIM during pregnancy had a 1.47-fold increased likelihood of having a child diagnosed with ASD. The likelihood was dose-dependent, with children of mothers taking four or more SBIMs during pregnancy having a 2.33-fold increased likelihood of having ASD. Of the nearly 200,000 children with an ASD diagnosis in the Epic Cosmos database, 14% had prenatal SBIM exposure.
Peeples and colleagues say physicians should consider alternatives to SBIMs when these are available, and avoid prescribing multiple SBIMs for pregnant women whenever possible.
The researchers say, “The public health implications of our findings are substantial. The medications we examined had approximately 400 million prescriptions in 2022, and nine of the 15 medications we studied were in the top 25 most prescribed medications in the U.S. Furthermore, our current study shows that SBIM utilization during pregnancy is sharply rising in the U.S.”
Karoly Mirnics, the study’s senior author, comments, “Our findings do not suggest that these medications are unsafe for adults. But they raise important questions about their use during pregnancy, a period when even small biochemical disruptions may have outsized effects on fetal brain development.”
The researchers stress that pregnant patients should not discontinue use of these medications without medical supervision, “as many SBIMs are essential, often life-saving treatments.” However, they say physicians should consider alternative treatments when these are available, and avoid prescribing multiple SBIMs for pregnant women whenever possible. In addition, they call for identification of both existing and new drugs that inhibit the sterol pathway; identification of patients with genetic vulnerabilities in sterol metabolism, who may be particularly sensitive to SBIM effects; increased physician education about the effects of SBIMs; and additional research into the mechanisms by which the drugs may affect fetal development.
“Sterol pathway disruption in pregnancy: a link to autism,” Eric S. Peeples, A. Jerrod Anzalone, Ran Dai, Elizabeth Reisher, Zeljka Korade, and Karoly Mirnics, Molecular Psychiatry, April 16, 2026 (free online). Address: Karoly Mirnics, Department of Pediatrics, University of Nebraska Medical Center, Omaha, NE 68198, [email protected].
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“Millions of US birth records uncover an autism risk surge tied to common drugs taken during pregnancy,” news release, University of Nebraska-Lincoln, April 20, 2026.
