Exposure to Selective Serotonin Reuptake Inhibitors in Early Pregnancy and the Risk of Miscarriage

Andersen, Jón Trærup; Andersen, Nis; Horwitz, Henrik; Poulsen, Henrik E.; Jimenez-Solem, Espen

doi:10.1097/aog.0000000000000447

Cited by 69 publications

(36 citation statements)

References 28 publications

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“…examined the relationship between antidepressant use and miscarriage using a pharmacy database. 21 The authors found an increased risk of miscarriage in those women taking antidepressants during the first trimester (1.27 HR; 95% CI 1.22-1.33) compared to women that did not. However, they found a similarly increased risk of miscarriage in those women that stopped the antidepressant prior to conceiving (1.24 HR, 95% CI 1.18-1.30).…”

Section: Discussionmentioning

confidence: 97%

The effect of antidepressants on fertility

Casilla-Lennon

Meltzer‐Brody

Steiner

2016

American Journal of Obstetrics and Gynecology

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BACKGROUND Information on the effects of different pharmaceuticals on fertility is sparse. Human and animal models indicate that antidepressant use could have a negative effect on fertility through alteration of levels of the neurosteroid, allopregnanolone. OBJECTIVE The objective of this study is to assess the effects of antidepressants on the natural fertility in women. STUDY DESIGN A secondary analysis of data from Time to Conceive, a prospective cohort study, was conducted. Women aged 30-44 without history of infertility, early in their attempts to conceive, were followed with standardized pregnancy testing until pregnancy was detected. Medication use was assessed at enrollment, daily for up to four months, and then monthly. For this analysis, discrete time regression models were created to calculate the association between antidepressant use and fecundability. Potential confounders: age, body mass index, caffeine, alcohol use, and education were included in all models. RESULTS Ninety-two (9.6%) of 957 women reported antidepressant use while attempting to conceive. Women taking antidepressants were more likely to be non-Hispanic Caucasian (91% vs. 75%, p<0.01) and to consume alcoholic beverages (74% vs. 61%, p<0.01). Antidepressant use at enrollment had an adjusted FR of 0.86 (95% CI: 0.63-1.20). However, time varying analyses suggested that antidepressant use in a given cycle is associated with a reduced probability of conceiving in that cycle (adjusted FR 0.75 95% CI: 0.53-1.06). After adjusting for history of depression or restricting the analysis to women who reported a history of depression, the association between antidepressant use and decreased fecundability remained [adjusted FR 0.66 (95% CI 0.45-0.97) and (adjusted FR 0.64, 95% CI: 0.43-0.94), respectively]. CONCLUSION Our data suggest that antidepressants may reduce the probability of a woman with a history of depression to conceive naturally. Future studies are needed to differentiate the extent to which this association is due to the antidepressant itself versus the underlying depression.

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Section: Discussionmentioning

confidence: 97%

The effect of antidepressants on fertility

Casilla-Lennon

Meltzer‐Brody

Steiner

2016

American Journal of Obstetrics and Gynecology

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“…20 A recent study by Andersen et al examined the relationship between antidepressant use and miscarriage using a pharmacy database. 21 The authors found an increased risk of miscarriage in those women taking antidepressants during the first trimester (1.27 HR; 95% CI 1.22-1.33) compared to women that did not. However, they found a similarly increased risk of miscarriage in those women that stopped the antidepressant prior to conceiving (1.24 HR, 95% CI 1.18-1.30).…”

Section: Discussionmentioning

confidence: 99%

The Effect of Antidepressants on Fertility

Casilla-Lennon

Chantala

Meltzer‐Brody

et al. 2015

Fertility and Sterility

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“…[66][67][68] Well conducted studies also suggest no increased risk for stillbirth or perinatal death with antenatal use of SSRIs. 69 70 Two large population based studies found no increased risk for hypertensive disorders in pregnancy from use of SSRIs in pregnancy among women with psychiatric disorders, although serotonin-norepinephrine reuptake inhibitors were associated with a small increased risk in one study.…”

Section: Effects Of Antidepressants In Pregnancymentioning

confidence: 99%