ArticlePharmacoepidemiology and drug safety2022
The role of prenatal exposure to antidepressants, anxiolytic, and hypnotics and its underlying illness on the risk of miscarriage using BIFAP database.
Article in Pharmacoepidemiology and drug safety, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 3 of them syntheses that pooled it.
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Who cites it
8 citing papers in PubMed, 3 syntheses or guidelines pooled it, 10 citations in OpenAlex.
- Risk of miscarriage after benzodiazepine use during pregnancy: updated systematic review and meta-analysis.BMC pregnancy and childbirth · 2026Pooled it
- Depression with risks for spontaneous abortion: a meta-analysis.BMC psychology · 2025Pooled it
- Association between antidepressant use during pregnancy and miscarriage: a systematic review and meta-analysis.BMJ open · 2024Pooled it
- Benzodiazepine exposure during early pregnancy and risk of miscarriage: dose-response, half-life classification, and individual agents.Archives of women's mental health · 2026Article
- First trimester antidepressant use and miscarriage: a population-based cohort study using Clinical Practice Research Datalink GOLD.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025Article
- Drug Exposure During Pregnancy: A Case-Control Study from a Primary Care Database.Women's health reports (New Rochelle, N.Y.) · 2024Article
- Drug exposure during pregnancy in primary care: an algorithm and observational study from SIDIAP database, Catalunya, Spain.BMJ open · 2023Observational
- The role of prenatal exposure to antidepressants, anxiolytic, and hypnotics and its underlying illness on the risk of miscarriage using BIFAP database.Pharmacoepidemiology and drug safety · 2022Article
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Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeDespite the notable increase on the prescription of antidepressants and anxiolytics during pregnancy, recommendation on maintaining the treatment during prenatal period is still controversial. We aimed to separately assess the role of effects of the antidepressants and anxiolytic and the underlying illness, controlled by potential confounding associated with miscarriage onset.
methodsWe used data from a validated pregnant cohort aged 15-49 years from 2002 to 2016 using BIFAP database. All confirmed miscarriages were used to perform a nested control analysis using conditional logistic regression. Women were classified according to use of each drug of interest into four mutually exclusive groups: nonusers, users only during prepregnancy, continuers, and initiators during first trimester. Adjusted odds ratios (aORs) for major confounders during pregnancy such as number of visits to primary care practitioners visits, obesity, smoking, HTA, diabetes with 95% confidence intervals were calculated.
resultsCompared with nonusers, antidepressants continuers had the highest increased risk of miscarriage aOR (95%) of 1.29 (1.13-1.46), being continuers of paroxetine and fluoxetine the antidepressants with the strongest association. Likewise, continuers of anxiolytics and initiators showed an increased risk of 1.19 (1.04-1.37) and 1.30 (1.13-1.50). When separating the effect between the condition itself or the treatment, women exposed during first trimester, regardless treatment duration and/or the underlying illness, had the highest risk 1.27 (1.08-1.51) for antidepressants and 1.25 (1.13-1.39) for anxiolytics.
conclusionsOur analysis showed an association between prenatal exposure to antidepressants and anxiolytics and miscarriage onset after controlling by potential confounding adjusting for confounders and the underlying illness. This association was not supported for hypnotic medications. Further studies are warranted to evaluate the risk of miscarriage among subpopulation of pregnant women requiring these medications.
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