Antidepressant use in pregnancy and severe cardiac malformations: Danish register‐based study

Abstract

Objective Studies restricted to live births may underestimate severe teratogenic effects. We address the limitation by including data from both prenatal and postnatal diagnoses of cardiac malformations.

Re: Antidepressant use and pregnancy: promoting risk minimisation for all teratogens is overdue

“…In our study, we used two or more redeemed prescriptions to define exposure with a prevalence of 1.1%. 1 The prevalence of pregnant women who redeemed one or more prescriptions was 3.2% (p. 3/Table S1), and even though this is likely to be an overestimation due to non-adherence, the estimates are in line with previously reported prevalences in Scandinavia. 2 Braillon and Bewley emphasise the need to also consider non-pharmacological treatment of some pregnant women with depression and, further, to provide evidence-based and individualised treatment of women of reproductive age.…”

“…First, Denmark seems to be a beacon of cautious prescribing: whereas the international prevalence estimate of selective serotonin reuptake inhibitor (SSRI) use during pregnancy is 3.0%, and increasing, in this series the prevalence of first-trimester exposure to antidepressants was only 1.1%. 1 Could Kolding and colleagues suggest explanations for this difference in order to improve affairs for pregnant women worldwide through benchmarking?…”

“…Kolding et al. must be commended for including terminations for abnormality within their methods and for providing the numbers needed to harm (NNH) when analysing the risk of cardiac malformations with antidepressant use, particularly during the first trimester of pregnancy 1 . However, further comments regarding policy implications are warranted.…”

Cortical Cross-Frequency Coupling Is Affected by in utero Exposure to Antidepressant Medication

“…Up to 5–8% of newborn infants are exposed to serotonin reuptake inhibitors (SRIs) used for treating major depressive disorder (MDD), anxiety disorders, and eating disorders, all of which commonly require medical care during pregnancy ( Andrade et al, 2008 ; Hanley and Mintzes, 2014 ; Charlton et al, 2015 ; Dawson et al, 2015 ). Such widespread use of SRIs during pregnancy is justified by the concerns that an untreated antenatal depression would affect early development of the offspring ( Hanley et al, 2015 ; Gentile, 2017 ; Kautzky et al, 2021 ) while the SRIs are not known to associate with major teratogenic effects other than possible cardiac issues ( Reefhuis et al, 2015 ; Wemakor et al, 2015 ; Wisner et al, 2020 ; Kolding et al, 2021 ). However, recent clinical findings have challenged the current liberal practice showing that newborn infants exposed to SRIs in utero show markedly high rates of SRI withdrawal symptoms requiring medical attention ( Ulbrich et al, 2021 ; Wang and Cosci, 2021 ).…”

Obstetric care for women that use antidepressants in pregnancy

“…Authors' response: Are these stillbirths really preventable? Re: Preventable stillbirths in India and Pakistan: a prospective, observational study Sir, We congratulate Goldenberg et al 1 on their prospective work on stillbirth in two countries: one with the highest number of stillbirths and the other with the highest stillbirth rate. We have been working with World Health Organization (WHO) South-East Asia Region to establish facility-based stillbirth surveillance in South-East Asia since 2011.…”