Is the exposure to antidepressant drugs in early pregnancy a risk factor for spontaneous abortion? A review of available evidences.
OBJECTIVE
To review studies conducted to establish the risk of spontaneous abortion (SA) in women exposed to antidepressant 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.
Santone
Giovanni
G
Psychiatric Unit, Department of Neuroscience, Polytechnic University of Marche, and United Hospitals of Ancona, Ancona, Italy. g.santone@ospedaliriuniti.marche.it
Ricchi
Gianmatteo
G
Rocchetti
David
D
Tofani
Stefania
S
Bellantuono
Cesario
C
D000022:Abortion, Spontaneous / Q000139:chemically induced*; D000928:Antidepressive Agents / Q000009:adverse effects*; D005260:Female; D006801:Humans; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D012307:Risk Factors
D000928:Antidepressive Agents