First antidepressant use not tied to first abortion

The study by Julia R. Steinberg, PhD, and her associates adds to the body of evidence showing that abortion is not associated with an increased risk of mental disorders, wrote Nada L. Stotland, MD, and Angela D. Shrestha, MD, in an editorial accompanying the article in JAMA Psychiatry (2018 May 30. doi: 10.1001/jamapsychiatry.2018.0838).

“The authors report that, compared with women who had not had an abortion, women who had a first abortion had a higher risk of first-time antidepressant prescription,” Dr. Stotland and Dr. Shrestha wrote. “However, the risk of first-time antidepressant prescription was similar to the year before and after an abortion. Giving birth was associated with a lower likelihood of a prescription, but this likelihood rose after childbirth and continued to rise for 5 years after delivery.”

Dr. Stotland and Dr. Shrestha also praised the methodology used by Dr. Steinberg and her associates, particularly the decision to make pregnant women who choose to remain pregnant a control group. However, women who opt to continue their pregnancies are more likely to have supportive and healthy circumstances that influence them to make that decision, Dr. Stotland and Dr. Shrestha said.

The decision to have an abortion is fraught with complexities. Ultimately, clinicians must recognize that abortions are indeed significant events for women, and offer them both accurate information and nonjudgmental support, they wrote.

Dr. Stotland is affiliated with Rush University in Chicago and the University of Illinois at Chicago. Dr. Shrestha also is affiliated with the University of Illinois at Chicago. They reported no conflicts of interest.