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Related Experiment Video

Updated: Jan 22, 2026

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Association between First Trimester Antidepressant Use and Risk of Spontaneous Abortion.

Pingsheng Wu1,2, Digna R Velez Edwards3,4,5,6, Phillip Gorrindo7

  • 1Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.

Pharmacotherapy
|July 7, 2019
PubMed
Summary

Maternal antidepressant use in early pregnancy may increase the risk of spontaneous abortion. Selective serotonin reuptake inhibitor (SSRI) use showed a significant association, but potential reporting bias needs consideration.

Keywords:
antidepressant useearly pregnancy lossfirst trimesterselective serotonin reuptake inhibitorspontaneous abortion

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Area of Science:

  • Reproductive Health
  • Perinatal Psychiatry
  • Obstetrics and Gynecology

Background:

  • Spontaneous abortion is a significant adverse pregnancy outcome.
  • The impact of maternal antidepressant use on spontaneous abortion risk is not fully understood.

Purpose of the Study:

  • To investigate the association between first-trimester antidepressant exposure and the risk of spontaneous abortion.

Main Methods:

  • Community-based prospective cohort study involving 5451 women.
  • First-trimester antidepressant use (including SSRIs) assessed via telephone interview.
  • Spontaneous abortion self-reported and verified by medical records; analyzed using Cox regression.

Main Results:

  • First-trimester antidepressant use was reported by 4% of women (223/5451).
  • Antidepressant users had a 34% higher risk of spontaneous abortion (aHR 1.34).
  • Selective serotonin reuptake inhibitor (SSRI) use was associated with a 45% increased risk (aHR 1.45), particularly when assessed after pregnancy loss, suggesting potential reporting bias.

Conclusions:

  • First-trimester SSRI use may be linked to an increased risk of spontaneous abortion.
  • The observed association was significant only when exposure was assessed after pregnancy loss, indicating potential reporting bias.
  • Future research should carefully consider the timing of data collection relative to pregnancy loss.