Gestational exposure to antidepressants and the risk of spontaneous abortion: a review.

@article{Broy2010GestationalET,
  title={Gestational exposure to antidepressants and the risk of spontaneous abortion: a review.},
  author={Perrine Broy and Anick B{\'e}rard},
  journal={Current drug delivery},
  year={2010},
  volume={7 1},
  pages={
          76-92
        }
}
BACKGROUND Although the relationship between antidepressant use during pregnancy and its adverse effects has been widely investigated, very few studies have evaluated the impact of antidepressant use during pregnancy on the risk of spontaneous abortion. We present an overview of the evidence relating to the association between antidepressant use during gestation and the risk of spontaneous abortion. METHODS We systematically searched PubMed and the reference lists of all relevant articles… 
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Use of antidepressants during pregnancy and the risk of spontaneous abortion
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The use of antidepressants, especially paroxetine, venlafaxine or the combined use of different classes of antidepressant, during pregnancy was associated with an increased risk of spontaneous abortion.
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Emerging evidence points to the need for a precision medicine approach to the treatment of pregnant women with depression, and results indicating that genetic variations in e.g. metabolism need to be taken into account are described.
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It is recommended that pregnant women exposed to any SSRI in early pregnancy be offered options for prenatal diagnosis through ultrasound examinations and fetal echocardiography to detect the presence of birth defects.
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This review highlights the importance of serotonin for embryonic development, the effect of serotonin inhibition during early pregnancy on the occurrence of multiple diverse malformations that have been shown to occur in human pregnancies, and the relevance of basic bioelectric and neurotransmitter mechanism for biomedicine.
ASSESSMENT OF THE POTENTIAL GENOTOXICITY AND CARDIAC TERATOGENICITY OF VENLAFAXINE ON EMBRYOS OF PREGNANT BLACK MICE
TLDR
Investigation of the effect of venlafaxine- one of the most widely prescribed SSRI (Selective serotonin reuptake inhibitors) on DNA, and its possible teratogenic effect on cardiac development showed a significant increase in the incidence of embryo heart anomalies in black mice.
Side effects of drugs essay: Observational studies in assessing benefits and harms: double standards?
Contemporary management of unipolar depression in the perinatal period
TLDR
The authors review the epidemiology of antenatal and postpartum depression and its impact on maternal and child health and the current status of the medical management and psychosocial interventions targeting perinatal depression.
Polymorphic variants of the serotonin receptor, 5-HT1A, and the serotonin transporter, 5-HTTLPR, and adverse pregnancy outcomes: A pilot study
Spontaneous abortion among women admitted into gynaecology wards of three selected hospitals in Maiduguri, Nigeria
TLDR
Based on the information obtained from the study, it was recommended that efforts should be concentrated on providing quality services for the management of post abortion complications.
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References

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Antidepressant Use during Pregnancy and the Rates of Spontaneous Abortions: A Meta-Analysis
TLDR
Maternal exposure to antidepressants may be associated with increased risk for SA; however, depression itself cannot be ruled out.
Rates of spontaneous and therapeutic abortions following use of antidepressants in pregnancy: results from a large prospective database.
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TLDR
To identify risk factors associated with treatment of major depression during pregnancy to help physicians develop treatment plans that optimize clinical care, prospective studies published since 1993 were selected.
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TLDR
The results suggest that the use of venlafaxine during pregnancy does not increase the rates of major malformations above the baseline rate of 1%-3%.
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TLDR
This study suggests a possible association between cardiovascular anomalies and first-trimester exposure to fluoxetine in mothers using selective serotonin reuptake inhibitors.
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TLDR
Mirtazapine does not appear to increase the baseline rate of major malformations in newborns when used by pregnant women, but the higher number of spontaneous abortions in the antidepressant groups confirms the higher rates of spontaneous pregnancies in pregnant women taking antidepressant medications found in previous studies.
Use of selective serotonin-reuptake inhibitors in pregnancy and the risk of birth defects
TLDR
This study failed to establish any association between the maternal use of SSRIs during early pregnancy and an elevated risk of congenital heart defects-or of several other classes of birth defects.
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TLDR
Gestational exposure to paroxetine is associated with major congenital malformations and major cardiac malformation for only first trimester exposure above 25 mg/day, and the dose-response relationship was observed.
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