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Is the exposure to antidepressant drugs in early pregnancy a risk factor for spontaneous abortion? A review of available evidences

Published online by Cambridge University Press:  11 April 2011

Giovanni Santone
Affiliation:
Psychiatric Unit, Department of Neuroscience, Polytechnic University of Marche, and United Hospitals of Ancona, Ancona (Italy)
Gianmatteo Ricchi
Affiliation:
Psychiatric Unit, Department of Neuroscience, Polytechnic University of Marche, and United Hospitals of Ancona, Ancona (Italy)
David Rocchetti
Affiliation:
Psychiatric Unit, Department of Neuroscience, Polytechnic University of Marche, and United Hospitals of Ancona, Ancona (Italy)
Stefania Tofani
Affiliation:
Psychiatric Unit, Department of Neuroscience, Polytechnic University of Marche, and United Hospitals of Ancona, Ancona (Italy)
Cesario Bellantuono
Affiliation:
Psychiatric Unit, Department of Neuroscience, Polytechnic University of Marche, and United Hospitals of Ancona, Ancona (Italy)
Corresponding

Summary

Aim – To review studies conducted to establish the risk of spontaneous abortion (SA) in women exposed to anti-depressant drugs (ADs) during early pregnancy. Methods – By using different search terms, PubMed, Toxline, EMBASE, PsychINFO, and the Cochrane library databases were searched from January 1980 to March 2008, to identify studies assessing the risk of SA in women exposed to different classes of ADs during the first trimester of pregnancy. Results – Ten studies over 21 identified were selected for the analysis. All were performed prospectively and included as control group unexposed women, or exposed to non-teratogenic drugs or to placebo. In seven studies a depressive episode was specified as the reason for which the drug was prescribed, while the time of exposure was in nine. Conclusions – Only three studies over ten selected reported a significant association between an increased rate of SAs and early pregnancy exposure to some ADs. Many methodological flaws in the study design were found in all studies considered. Given this background and a lack of strong evidence on this issue, further prospective and better designed studies are needed to assess the risk of SA in pregnant women exposed to ADs against the risk of an untreated maternal depression.

Declaration of Interest: None.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2009

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Is the exposure to antidepressant drugs in early pregnancy a risk factor for spontaneous abortion? A review of available evidences
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