Use of antidepressants during pregnancy and the risk of spontaneous abortion

Nakhai-Pour, Hamid Reza; Broy, Perrine; Bérard, Anick
July 2010
CMAJ: Canadian Medical Association Journal;7/13/2010, Vol. 182 Issue 10, p1031
Academic Journal
Background: The risk of relapse of depression or the diagnosis of some other psychiatric disorders during pregnancy necessitates the use of antidepressants despite possible adverse effects. Whether such use increases the risk of spontaneous abortion is still being debated. We evaluated the risk of spontaneous abortion in relation to the use of antidepressants during pregnancy. Methods: Using a nested case-control study design, we obtained data from the Quebec Pregnancy Registry for 5124 women who had a clinically detected spontaneous abortion. For each case, we randomly selected 10 controls from the remaining women in the registry who were matched by the case's index date (date of spontaneous abortion) and gestational age at the time of spontaneous abortion. Use of antidepressants was defined by filled prescriptions and was compared with nonuse. We also studied the classes, types and doses of antidepressants. Results: A total of 284 (5.5%) of the women who had a spontaneous abortion had at least one prescription for an anti depressant filled during the pregnancy, as compared with 1401 (2.7%) of the matched controls (odds ratio [OR] 2.09, 95% confidence interval [CI] 1.83-2.38). After adjustment for potential confounders, we found that the use of antidepressants during pregnancy was associated with an increased risk of spontaneous abortion (OR 1.68, 95%CI 1.38-2.06). Stratified analyses showed that use of selectiveserotonin reuptake inhibitors alone (OR 1.61, 95% CI 1.28- 2.04), serotonin- norepinephrine reuptake inhibitors alone (OR 2.11, 95% CI 1.34-3.30) and combined use of antidepressants from different classes (OR 3.51, 95% CI 2.20-5.61) were associated with an increased risk of spontaneous abortion. When we looked at antidepressant use by type versus no use, paroxetine use alone (OR 1.75, 95% CI 1.31-2.34) and venlafaxine use alone (OR 2.11, 95% CI 1.34-3.30) were associated with an increased risk of spontaneous abortion. Interpretation: The use of antidepressants, especially paroxetine, venlafaxine or the combined use of different classes of antidepressants, during pregnancy was associated with an increased risk of spontaneous abortion.


Related Articles

  • Gestational Exposure to Antidepressants and the Risk of Spontaneous Abortion: A Review. Broy, Perrine; Bérard, Anick // Current Drug Delivery;Jan2010, Vol. 7 Issue 1, p76 

    Background. Although the relationship between antidepressant use during pregnancy and its adverse effects has been widely investigated, very few studies have evaluated the impact of antidepressant use during pregnancy on the risk of spontaneous abortion. We present an overview of the evidence...

  • Antidepressant use increases the risk for miscarriage.  // Contemporary OB/GYN;Aug2010, Vol. 55 Issue 8, p4 

    The article focuses on a study, which showed that pregnant women who take antidepressants have a 68% increased risk for miscarriage compared with women not taking drugs.

  • Should I Drop My Antidepressant? Szalavitz, Maia // Psychology Today;Mar/Apr2006, Vol. 39 Issue 2, p59 

    The article focuses on the necessity of taking antidepressants to pregnant women. There are no evidence that antidepressants can affect fetuses and newborns. One of the threats posed by depression to the unborn are miscarriage, premature birth, low birth weight and fetal growth problems. Studies...

  • Venlafaxine.  // Reactions Weekly;12/2/2006, Issue 1130, p26 

    The article presents case reports of two neonates who developed seizures following in utero exposure to venlafaxine. It references a study by R. K. Pakalapati et al published in the November 2006 issue of the "Journal of Paediatrics and Child Health." The medical histories of the mothers of the...

  • Bupropion.  // Reactions Weekly;8/30/2008, Issue 1217, p9 

    The article describes the case of a 31-year-old woman who started receiving bupropion for unipolar depression. She presented with elated mood, decreased need for sleep, increased energy level and racing thoughts. The drug was discontinued and her hypomanic symptoms subsided. She then continued...

  • Duloxetine/venlafaxine.  // Reactions Weekly;1/24/2009, Issue 1236, p17 

    The article describes the case of a 23-year-old woman with therapy-resistant depression who developed exanthema while receiving venlafaxine, and ecchymosis after her treatment was changed to duloxetine. The patient developed a generalised, micromacular and extremely pruritic exanthema after 7...

  • Citalopram/herbal medicines interaction.  // Reactions Weekly;9/20/2008, Issue 1220, p8 

    The article describes the case of a 60-year-old woman receiving citalopram for recurrent depressive disorders who developed cognitive and depressive symptoms after she started taking a herbal medicine called healing earth. The dosage of the citalopram being given to the patient was reduced after...

  • Report your own adverse effects. Robinson, Jean // AIMS Journal;2005, Vol. 17 Issue 4, p14 

    The article reports on the need for pregnant women to report the adverse effects of pregnancy medication to the Great Britain Medicines and Healthcare products Regulatory Agency (MHRA). For instance, some oral contraceptives can induce mood changes such as depression. The MHRA assures...

  • Warfarin.  // Reactions Weekly;Jul2015, Vol. 1559 Issue 1, p180 

    An abstract of the article "Prosthetic mitral valve thrombosis in pregnancy: From thrombolysis to anticoagulation," by G. Cardoso and colleagues is presented.


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics