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Antidepressants Associated With Miscarriage

Researchers find antidepressant use during pregnancy may increase risk of spontaneous abortion

TUESDAY, June 1 (HealthDay News) -- Use of antidepressants during pregnancy, particularly paroxetine, venlafaxine, or a combination of different antidepressant classes, may increase the risk of miscarriage by 68 percent, according to research published online May 31 in CMAJ, the journal of the Canadian Medical Association.

Hamid Reza Nakhai-Pour, M.D., of the University of Montreal, and colleagues conducted a nested case-control study of 5,124 women who had a spontaneous abortion, each of whom were matched to 10 randomly selected controls, and assessed the presence or absence of antidepressant exposure to determine whether the use of antidepressants increases the risk of miscarriage.

The researchers found that 284 (5.5 percent) of the women who miscarried had at least one prescription for an antidepressant filled during the pregnancy, compared with 1,401 (2.7 percent) of the matched controls. After adjusting for potential confounders, they determined that antidepressant use during pregnancy was linked to a 68 percent increased risk of spontaneous abortion. They found that selective serotonin reuptake inhibitors alone were associated with a 61 percent increased risk; serotonin-norepinephrine reuptake inhibitors alone, use of antidepressants from different classes, paroxetine, and venlafaxine were also associated with an increased risk (odds ratios, 2.11, 3.51, 1.75, 2.11, respectively).

"In light of our results, physicians who have patients of childbearing age taking antidepressants or have pregnant patients who require antidepressant therapy early in pregnancy may wish to discuss the risks and benefits with them," the authors write.

One author disclosed being a consultant for a plaintiff in litigation involving Paxil.

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