Use of anti-depressants ups risk of miscarriage

TORONTO - The use of anti-depressants ups the overall risk of miscarriage by 68 percent. Anti-depressants are widely used in pregnancy and up to 3.7 percent of women use them at some point during the first trimester, says a study.

Discontinuing treatment can result in a depressive relapse which can put mother and baby at risk. Most previous studies on the use of anti-depressants in pregnancy did not look at miscarriages as a main outcome, had small samples and several showed contradictory results.

University of Montreal (UM) researchers looked at data on 5,124 women in Quebec who had clinically verified miscarriages up to 20 weeks of gestation and a large sample of women from the same registry who did not have a miscarriage.

Of those who miscarried, 284 (5.5 percent) had taken anti-depressants during pregnancy.

Selective serotonin reuptake inhibitors (SSRIs), especially paroxetine and also venlafaxine, were associated with increased risk of miscarriage as were higher daily doses of either anti-depressant.

Besides, a combination of different anti-depressants doubled the risk of miscarriages.

SSRIs are a class of compounds typically used in the treatment of depression, anxiety disorders, and some personality disorders. They are also used in treating premature ejaculation problems as well as some cases of insomnia.

“These results, which suggest an overall class effect of selective serotonin reuptake inhibitors, are highly robust given the large number of users studied,” writes senior study author Anick Bérard, from University of Montreal, said its release.

The researchers urge that physicians who have patients of child-bearing age taking anti-depressants or have pregnant patients who require anti-depressant therapy early in pregnancy discuss the risks and benefits with them.