• Article

Depression, anxiety, and psychotropic medication use and fecundability


Nillni, Y. I., Wesselink, A. K., Gradus, J. L., Hatch, E. E., Rothman, K., Mikkelsen, E. M., & Wise, L. A. (2016). Depression, anxiety, and psychotropic medication use and fecundability. American Journal of Obstetrics and Gynecology, Advance Online Publication. DOI: 10.1016/j.ajog.2016.04.022


BACKGROUND: The literature regarding the associations between depression, anxiety, and fecundity is inconsistent. While cross-sectional studies suggest that depression and/or anxiety may adversely affect fecundity, the sole cohort study showed only a small association. OBJECTIVE: We sought to evaluate the association of self-reported depressive symptoms, self-reported diagnoses of depression and anxiety, and psychotropic medication use with fecundability in a prospective cohort study. STUDY DESIGN: Data were derived from Pregnancy Study Online (PRESTO), an Internet-based preconception cohort study of couples attempting to conceive in the United States and Canada. At baseline, female participants completed a survey that assessed demographic information, history of physician-diagnosed depression and anxiety, self-reported depressive symptoms (assessed by the Major Depression Inventory), and use of psychotropic medications. Women completed follow-up surveys every 8 weeks for up to 12 months or until reported conception to assess changes in exposures and pregnancy status. We estimated fecundability ratios and 95% confidence intervals using proportional probabilities regression models. The analysis was restricted to 2146 women who had been attempting to conceive for