Contraceptives as possible risk factors for postpartum depression: A retrospective study of the food and drug administration adverse event reporting system, 2004-2015.

The study analysed voluntary adverse-event reports, not a defined population of women using each drug, so it cannot show how common postpartum depression is with these contraceptives. Childbirth date and drug start or end dates were not coded, so the timing of contraception relative to delivery or depression onset could not be evaluated. Known risk factors for postpartum depression, such as prior depression, stress, social support, unwanted pregnancy, primiparity and older maternal age, were not adjusted for. The reporting odds ratio is exploratory; the authors state it cannot establish causality and only gives a rough indication of signal strength. Only reports where the drug was coded as primary suspect were included, so other drugs or conditions in the same report cannot be separated.

One author is an employee of Medical Database. The remaining authors declared no conflict of interest.

Do not read the reporting odds ratios as proof that levonorgestrel, etonogestrel, drospirenone, sertraline, fluoxetine, topiramate, quetiapine or tretinoin caused postpartum depression. The study analysed voluntary reports, included only the drug coded as primary suspect, could not date childbirth or drug exposure, and did not adjust for confounders.