Use of antidepressants and association with elective termination of pregnancy: population based case-control study

作者：Kieler H^*; Malm H; Artama M; Engeland A; Furu K; Gissler M; Norgaard M; Stephansson O; Valdimarsdottir U; Zoega H; Haglund B

来源：BJOG: An International Journal of Obstetrics and Gynaecology , 2015, 122(12): 1618-1624.

DOI：10.1111/1471-0528.13164

• Antidepressants
• fetal anomaly
• socio-economic disadvantage
• termination of pregnancy

ObjectiveTo assess whether the use of selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants, mirtazapine, venlafaxine or other antidepressants is associated with late elective termination of pregnancy.
DesignCase-control study using data from national registers.
SettingDenmark, Finland, and Norway during the period 1996-2007.
PopulationA total of 14902 women were included as cases and 148929 women were included as controls.
MethodsCases were women with elective termination of pregnancy at 12-23weeks of gestation. Controls continued their pregnancy and were matched with cases on key factors.
Main outcome measuresAssociation between antidepressant use during pregnancy and elective termination of pregnancy at 12-23weeks of gestation for fetal anomalies, or for maternal ill health or socio-economic disadvantage.
ResultsAt least one prescription of antidepressants was filled by 3.7% of the cases and 2.2% of the controls. Use of any type of antidepressant was associated with elective termination of pregnancy for maternal ill health or socio-economic disadvantage (odds ratio, OR 2.3; 95% confidence interval, 95% CI 2.0-2.5). Elective termination of pregnancy for fetal anomalies was associated with the use of mirtazapine (OR 2.2, 95% CI 1.1-4.5). There was no association between the use of any of the other antidepressants and elective termination of pregnancy for fetal anomalies.
ConclusionThe use of any type of antidepressants was associated with elective termination of pregnancy at 12-23weeks for maternal ill health or socio-economic disadvantage, but not with terminations for fetal anomalies. Further studies need to confirm the findings concerning mirtazapine and termination of pregnancy for fetal anomalies.

• 出版日期2015-11