{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T03:13:18Z","timestamp":1778728398033,"version":"3.51.4"},"reference-count":37,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2019,7,25]],"date-time":"2019-07-25T00:00:00Z","timestamp":1564012800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["R01HD043883"],"award-info":[{"award-number":["R01HD043883"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["R01HD049675"],"award-info":[{"award-number":["R01HD049675"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1TR000445"],"award-info":[{"award-number":["UL1TR000445"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K12HD043483"],"award-info":[{"award-number":["K12HD043483"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006407","name":"American Water Works Association Research Foundation","doi-asserted-by":"publisher","award":["2579"],"award-info":[{"award-number":["2579"]}],"id":[{"id":"10.13039\/100006407","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2019,9]]},"abstract":"\n Study Objective<\/jats:title>\n The potential for maternal antidepressant use to influence the risk of spontaneous abortion, one of the most important adverse pregnancy outcomes, is not clear. We aimed to assess whether first trimester antidepressant exposure was associated with an increased risk of spontaneous abortion.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n Community\u2010based prospective cohort study (Right from the Start).<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n Eight metropolitan areas in North Carolina, Tennessee, and Texas.<\/jats:p>\n <\/jats:sec>\n \n Participants<\/jats:title>\n \n A total of 5451 women (18\u00a0years of age or older) who were planning to conceive or were pregnant (before 12\u00a0weeks of completed gestation) and were enrolled in the study between 2000 and 2012; of those women, 223 used antidepressants (selective serotonin reuptake inhibitors [\n SSRI<\/jats:styled-content>\n s] only [170],\n SSRI<\/jats:styled-content>\n s and non\u2010\n SSRI<\/jats:styled-content>\n s [9], and non\u2010\n SSRI<\/jats:styled-content>\n s only [44]) during their first trimester, and 5228 did not (never users).\n <\/jats:p>\n <\/jats:sec>\n \n \n \n Measurements and Main Results<\/jats:title>\n \n First trimester antidepressant use was determined during a first trimester telephone interview. Spontaneous abortion was self\u2010reported and verified by medical records. The association of first trimester antidepressant use and spontaneous abortion was assessed by using Cox proportional hazard regression. Among the 5451 women enrolled, 223 (4%) reported first trimester antidepressant use, and 659 (12%) experienced a spontaneous abortion.\n SSRI<\/jats:styled-content>\n s were the most common class of antidepressants used (179 [80%]). Compared with women who never used antidepressants during the first trimester of pregnancy, women who reported antidepressant use were 34% (adjusted hazard ratio [\n aHR<\/jats:styled-content>\n ] 1.34, 95% confidence interval [\n CI<\/jats:styled-content>\n ] 0.97\u20131.85) more likely to experience a spontaneous abortion after adjusting for covariates. Women who reported ever using\n SSRI<\/jats:styled-content>\n s were 45% (\n aHR<\/jats:styled-content>\n 1.45, 95%\n CI<\/jats:styled-content>\n 1.02\u20132.06) more likely to experience a spontaneous abortion compared with never users. When time of loss relative to the time of interview was taken into consideration, the association between first trimester\n SSRI<\/jats:styled-content>\n use and spontaneous abortion was significant only among those with losses before the interview (\n aHR<\/jats:styled-content>\n 1.49, 95%\n CI<\/jats:styled-content>\n 1.04\u20132.13) but was not significant among those with losses after the interview (\n aHR<\/jats:styled-content>\n 0.43, 95%\n CI<\/jats:styled-content>\n 0.06\u20133.15).\n <\/jats:p>\n <\/jats:sec>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n The association between use of first trimester antidepressants, particularly\n SSRI<\/jats:styled-content>\n use, and spontaneous abortion was significant only among women whose exposure status was assessed after loss. In this instance, reporting bias may create a spurious association. Future studies should take the timing of data collection relative to the timing of loss into consideration.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/phar.2308","type":"journal-article","created":{"date-parts":[[2019,7,6]],"date-time":"2019-07-06T06:43:08Z","timestamp":1562395388000},"page":"889-898","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Association between First Trimester Antidepressant Use and Risk of Spontaneous Abortion"],"prefix":"10.1002","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4947-3063","authenticated-orcid":false,"given":"Pingsheng","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Medicine Vanderbilt University Medical Center Nashville Tennessee"},{"name":"Department of Biostatistics Vanderbilt University Medical Center Nashville Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Digna R.","family":"Velez 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