What motivated you to come to Bristol and do this programme? 

The thing that initially drew me to Bristol and subsequently led me to the Wellcome PhD programme was the new Epidemiology MSc offered by the Population Health Sciences department. I had been looking for suitable PhD projects prior to this and thought the MSc could buy me some time and additional experience. The first seminar we had was led by a then-current MGLE student, whose PhD was closely aligned with my interests and the programme he was on sounded great. Having unsuccessfully applied for other programmes and projects, I knew that the Wellcome programme stood out in terms of research time and budget, and I was quickly realising that the Integrative Epidemiology Unit at Bristol was where I wanted to pursue Epidemiology for my doctorate. 

What is the key research question of your PhD research project and what have you found out so far? 

My main PhD project is called “Antidepressant use during pregnancy: what are the outcomes?” and I am using general practice (GP) data to investigate this question. Antidepressants are widely prescribed medications in the UK, with over 70 million prescriptions made in 2018 alone. These data from Public Health England also show that women are 1.5 times more likely to fill a prescription than men, suggesting that there is a significant burden of antidepressant use among those who might become pregnant.  

Antidepressants are not contraindicated in pregnancy, in other words GP’s will prescribe them in pregnancy if a pregnant patient needs them. However, risk of adverse outcomes like miscarriage haven’t been confirmed nor denied by the research literature. Studying outcomes following antidepressant use during pregnancy is difficult because we can’t perform randomised controlled trials (RCTs), which are the gold standard for assessing cause and effect. Instead, we rely on observational data, meaning we collect data on people who have taken antidepressants during pregnancy in the population and compare them to those who didn’t. Observational data is problematic because we have issues like confounding, where the “exposed” group share different characteristics more commonly with each other than with the “unexposed” group, which, if not properly balanced, can give you misleading results.  

So far in my project, I have completed two mini projects, one on adolescent menstruation and the other on alcohol intake during pregnancy (linked here). I have also completed a systematic review of antidepressant use during pregnancy and stillbirth, showing that despite the literature as a whole in this area suggesting a slight increased risk of stillbirth following antidepressant use, it is likely to be a result of confounding as opposed to a causal effect. 

Where do you think your research could lead and what are your future career plans now? 

I’m hoping my PhD research will contribute to field of pregnancy pharmacoepidemiology, providing more pieces of high-quality evidence that can aid in informing people’s choices if they find themselves pregnant and in need of antidepressants. In the future, I would like to carry on my work in perinatal epidemiology, particularly medicine use and pregnancy.