Evidence map›Paper›PMID 38272551›Full record

SynthesisBMJ open2024

Association between antidepressant use during pregnancy and miscarriage: a systematic review and meta-analysis.

Sophie Smith, Flo Martin, Dheeraj Rai, Harriet Forbes

Abstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in BMJ open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Patterns of antidepressant prescribing around pregnancy: a descriptive analysis using Clinical Practice Research Datalink GOLD.The British journal of general practice : the journal of the Royal College of General Practitioners · 2026
    Article
  5. 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 · 2025
    Article
  6. Article
  7. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Sophie SmithCentre for Academic Mental Health, Population Health Sciences, University of Bristol, Bristol, UK sophie.smith@bristol.ac.uk.ORCID 0000-0002-1248-5477
Flo MartinMRC Integrative Epidemiology Unit, Population Health Sciences, University of Bristol, Bristol, UK.
Dheeraj RaiCentre for Academic Mental Health, Population Health Sciences, University of Bristol, Bristol, UK.
Harriet ForbesLondon School of Hygiene and Tropical Medicine, London, UK.

Funding

Maternal epilepsy, antiepileptic drug use during pregnancy, and risk of autismR01NS107607 · NINDS · DREXEL UNIVERSITY · PI LEE, BRIAN KANE, MAGNUSSON, CECILIA · 2019 to 2022
$1.7M
NINDS NIH HHS R01 NS107607Wellcome Trust
6 · The paper itself

Abstract

backgroundLiterature surrounding the association between antidepressant use during pregnancy and miscarriage is conflicting. We aimed to conduct a systematic review and meta-analysis of studies among pregnant women regarding the association between exposure to antidepressants during pregnancy and the risk of miscarriage, compared with pregnant women not exposed to antidepressants.

designWe conducted a systematic review and meta-analysis of non-randomised studies. DATA SOURCES: We searched Medline, Embase and PsychINFO up to 6 August 2023. ELIGIBILITY CRITERIA AND OUTCOMES: Case-control, cohort and cross-sectional study designs were selected if they compared individuals exposed to any antidepressant class during pregnancy to comparator groups of either no antidepressant use or an alternate antidepressant. DATA EXTRACTION AND SYNTHESIS: Effect estimates were extracted from selected studies and pooled using a random-effects meta-analysis. Risk of bias (RoB) was assessed using the Risk of Bias in Non-Randomised Studies of Interventions (ROBINS-I) tool, and heterogeneity assessed using the I

results1800 records were identified from the search, of which 29 were included in the systematic review and meta-analysis. The total sample included 5 671 135 individuals. Antidepressant users initially appeared to have a higher risk of miscarriage compared with unexposed individuals from the general population (summary effect estimate: 1.24, 95% CI 1.18 to 1.31, I

conclusionsAfter accounting for maternal depression, there is little evidence of any association between antidepressant use during pregnancy and miscarriage. Instead, the results indicate the biasing impact of confounding by indication.

Indexed as

Abortion, SpontaneousAntidepressive AgentsCross-Sectional StudiesFemaleHumansPregnancyAntidepressive AgentsDepression & mood disordersEPIDEMIOLOGYMaternal medicine

Identifiers

PMID38272551
PMCPMC10824002

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.