Thursday, June 23, 2011

Miscarriage and Antidepressants

[Transparency: I have edited this post with updated info, so that I don't add to the strew of misinformation around this subject]

Some of my major fears about carrying a child while on antidepressants were dealt with directly when we had our last meeting with the reproductive psych.  Finally, everything I've read about congenital heart disease in newborns, tremors, developmental delays, addiction, major cleft palate and cleft lip, respiratory issues, etc etc etc., were addressed.

The doc said that there are three risks that have been well demonstrated, and therefore believed to be true. And tonight, I want to address just one. (Check back for others soon).

Pregnant women that are on antidepressants are more likely to miscarry than women that are not. But how much more likely?

And that's the thing that drives me nuts, and that I keep running into when it comes to the literature on antidepressants and pregnancy. An article in TIME and and article on CBC News both report on the same study in Quebec on the link between miscarriage and antidepressant use. Ready? Remember - this is the SAME study...

From TIME: "Researchers calculated that antidepressant users had a 68% higher risk of miscarriage than nonusers, after controlling for other influences that could potentially confound the association."

From CBC"A study of 5,124 women in Quebec who had lost fetuses in pregnancy showed a 1.68 times higher risk of miscarriage among those who were prescribed antidepressants."

I've edited this post since I originally wrote it, because a wonderful reader pointed out that 68 and 1.68 are the same numbers... which in my haste and excitement, went over my head. And I don't want to add to the misinformation out there in the cybersphere. It just makes me realize that however educated I feel I am, specifically when it comes to reading about research, I get overwhelmed and confused by the literature and tend to get lost. And I can't be the only one.

This study - which asserts that women taking antidepressants have a 68% higher risk of miscarriage - is cited in every single link but one in the first 15 pages of Google search results for "miscarriage and antidepressants". I'm not saying that is a bad thing or a good thing; it just goes to show that once media pick up a story like this, it lasts forever. This is the result that people see when they do their research online. Based on one study.

And this is why I get frustrated with medical literature and the media that follows. It's hard to know what's a true representation of the source AND a true representation of a researchers results. And almost every study I read (from medical journals, not media), the results are either inconclusive or there is not enough evidence to suggest a risk. There is a huge unknown - and part of me realizes that this is a good thing. I am trying to be as informed as I can be, but the lack of evidence and the crappy reporting and the stigma around the whole issue makes it hard. 

So yes, there is a risk of miscarriage. At least, out of just over 5,000 women in the study. But both articles mentioned that researchers still don't know whether it was the depression itself that caused the miscarriage or the antidepressants taken to treat depression. 

I think I might be driving myself crazy wanting to "be informed". The information is so flippin' convoluted that I don't even know what to think anymore. It just makes me scared. Scared that I'm going to lose child after child, and then finally when I have a live birth, the baby is going to be so sick and malformed.
Awesome.

4 comments:

  1. Big hugs to you, chica :( Sorry to hear this is all so disheartening...kudos to you for wanting to be so very informed...just wish it was not such hard info to digest :(

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  2. Relax and breathe. You will be fine, the baby will be fine. Think of what some women do when pregnant and still the baby is born absolutely fine and you are so bright about all this it will be terrific. Stop reading the journals and start trying to have that baby. :)

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  3. Those numbers are the same: 68% higher is 1.68 times. It just sounds much more scary, which is probably why they chose to go with it--scare tactics bring in more readers. Just remember that 168% of a low number is still a low number, and there's no reason to think that you'll be part of that cohort. Jeez. I sound like a downer. What I'm trying to say is this: All of us might have to face miscarriage due to any number of circumstances that we can't control. But the far greater likelihood is that we'll have perfect, healthy babies--and your doctors are taking good care of you--much better care than most women get, so your chances are excellent.

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  4. Hmmm... maybe I should practice my math :-S

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