Study evaluates risk of anti-depressant use and miscarriage

Canadian researchers say they found that pregnant women who take antidepressants during the first trimester may have an increased risk of miscarriage.

Researchers from the University of Montreal studied over 5000 women who had miscarriages and compared them to a group of women who carried their babies to term. This is one of the largest sample of women studied for this issue to date. Of the women who had miscarriages, 284 were taking anti-depressants, making them almost twice as likely to have a miscarriage compared to women who were not on these medications.

Dr. Peter Gearhart of Penn ObGyn and Midwifery care in Philadelphia says while this may sound alarming, one can’t be sure that the anti-depressants are to blame:

Gearhart: There may be other factors in the population of patients that are taking the medication that predispose them to miscarriages, so they may already be at risk for miscarriage, whether or not they are taking the medication. There probably is some validity to the effect of the medication on the risk of miscarriage but to what degree is often difficult to assess.

Dr. Deborah Kim is the medical director of the perinatal mood and anxiety disorder clinic at the University of Pennsylvania. She says that antidepressants may increase the risk of miscarriage, but the overall risk is still low, and not taking medications carries other risks:

Kim: Women who are depressed and pregnant are less likely to get prenatal care, they are more likely to abuse substances including nicotine – you know, you have to weight the risk and benefits of treatment vs non-treatment.

Kim and Gearhart say pregnant women should discuss their use of anti-depressants with their doctors as early as possible. Many women are able to go off anti-depressants during pregnancy by relying on therapy, diet, exercise and regular sleep, but Kim says for more severely depressed women, stopping anti-depressant use is not advisable.