Women's Health Watch

Antidepressants May Increase Risk of Miscarriage

An observational study published in the June 2010 issue of the Canadian Medical Association Journal suggests that pregnant women who take antidepressants have an increased risk of miscarriage.

Based at the University of Montreal and at the CHU Sainte-Justine Mother and Child University Hospital in Montreal, Canada, the researchers examined data on 69,742 women from the Quebec Pregnancy Registry. In the study sample, 5124 women had a miscarriage.

Of the women who miscarried, 5.5% had filled a prescription for an antidepressant during their pregnancy. The study authors found that pregnant women who took antidepressants had a 68% increased risk of miscarriage compared with women who had never used an antidepressant. There was a 19% increased risk of miscarriage among women with a history of depression.

Anick Berard, PhD, senior study author and director of the research unit on medications and pregnancy at the University of Montreal, says that more research is needed, but it appears that “antidepressants have a mediated serotonin effect that would put pressure on the uterus at a very early stage of pregnancy.”

Depression is common during pregnancy, and the study authors urge clinicians to find a balance that is best for their patients. Although this study suggests avoiding antidepressant use during pregnancy, if possible, discontinuing needed therapy can also put a mother and baby at risk.

The Birth Control Pill Marks 50 Years on US Market

The birth control pill was first approved by the FDA in May 1960, making this year the 50th anniversary of the contraceptive’s path to the US marketplace. In its 5-decade history, the birth control pill has allowed women to plan their pregnancies safely and effectively and has become a common form of contraception.

“Use of Contraception in the United States: 1982-2008,” a recent report from the National Center for Health Statistics, a division of the Centers for Disease Control and Prevention, found that the pill was the most popular form of contraception among women between the ages of 15 and 44 years between 2006 and 2008. During that time period, 10.7 million women used an oral contraceptive.

The pill has evolved—the earliest versions of the oral contraceptives contained nearly 10 times the amount of progestin and 4 times the amount of estrogen as modern formulations. It has also paved the way for other forms of hormonal contraception.

According to Hal Lawrence, MD, vice president of practice activities at the American College of Obstetricians and Gynecologists, women today may choose the birth control pill for its protective benefits as well as its effectiveness in preventing pregnancy. “The longer a woman is on the pill, the greater her protection against ovarian cancer. Long-term pill use can lower the risk of ovarian cancer by about 40%, and possibly up to 80% for women who take the pill for a decade or more,” Dr. Lawrence said.

The birth control pill also reduces the risk of endometrial cancer—the most common gynecologic cancer in the United States—and prevents a host of other conditions, such as severe pelvic inflammatory disease, acne, heavy uterine bleeding, and pain from endometriosis.

Prevent COPD with Vitamin E

Research presented at the American Thoracic Society’s annual international conference suggests that women who take vitamin E supplements can reduce their risk of developing chronic obstructive pulmonary disease (COPD).

The team of researchers from Cornell University in Ithaca, New York, and Brigham and Women’s Hospital in Boston, Massachusetts, analyzed data from the Women’s Health Study. Their investigation included 39,876 women health care professionals, who received 600 IU of vitamin E or placebo for a mean of 9.8 years. The final analysis included 19,299 women in the vitamin E group and 19,298 in the placebo group.

Even after adjusting for factors such as smoking, asthma, diabetes, body mass index, and multivitamin use, 760 women in the vitamin E group developed COPD, compared with 846 in the placebo group.

The researchers noted that the oxidant/antioxidant balance in lung tissue has long been believed to influence the development of COPD, but this is the first observational study to suggest that use of vitamin E can actually prevent the condition.

Fast Fact: Gout is more common in women after they have reached menopause.