Effects of depression pharmacotherapy in fertility treatment on conception, birth, and neonatal health: A systematic review

Akioyamen, Leo E.; Minhas, Hersimren; Holloway, Alison C.; Taylor, Valerie H.; Akioyamen, Noel O; Sherifali, Diana

doi:10.1016/j.jpsychores.2016.03.015

Cited by 12 publications

(9 citation statements)

References 58 publications

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“…However, clinically it remains unknown if antidepressant use influences embryo quality, implantation and pregnancy rate. [45] Four small studies have previously been published on this topic, with no definitive conclusions. Two retrospective chart reviews found no statistically significant differences in pregnancy rates in women taking SSRIs and those not taking SSRIs.…”

Section: The Influence Of Stress Depression and Its Treatment On Armentioning

confidence: 99%

Polycystic ovary syndrome and psychiatric disorders: Co-morbidity and heritability in a nationwide Swedish cohort

Cesta

Månsson

Palm

et al. 2016

Psychoneuroendocrinology

172

141

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Section: The Influence Of Stress Depression and Its Treatment On Armentioning

confidence: 99%

Polycystic ovary syndrome and psychiatric disorders: Co-morbidity and heritability in a nationwide Swedish cohort

Cesta

Månsson

Palm

et al. 2016

Psychoneuroendocrinology

172

141

View full text Add to dashboard Cite

“…Whereas, a recent critical review [ 8 ] found psychosocial interventions improved psychological and pregnancy outcomes. However, Akioyamen et al [ 9 ] found the use of antidepressants had no impact on fertility treatment pregnancy rates.…”

Section: Introductionmentioning

confidence: 99%

A systematic review and meta-analysis of psychological predictors of successful assisted reproductive technologies

2017

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ObjectivesThe aim of this systematic review and meta-analysis was to perform an updated investigation of the effects of depression and anxiety on pregnancy outcomes following assisted reproductive technologies. A bibliographic search was performed using PubMed, PsycINFO, Embase, Science Direct databases. Data retrieved were analysed using a random effects model to estimate standardised mean differences.ResultsOf the 22 included studies, 18 investigated depression, 15 state anxiety, and seven trait anxiety. Data from 4018 patients were included in the meta-analysis. Results indicated that women who achieved pregnancy or a live birth reported lower levels of depression pre-treatment than those who did not, although the effects were small d = − 0.177 (95% CI − 0.327 to − 0.027, z = 2.309, p = 0.021). These results were consistent under different methodological conditions and the quality of these observational were graded as satisfactory. A similar pattern was seen for state (d = − 0.096, 95% CI − 0.180 to − 0.012: z = 2.241, p = 0.025) and trait anxiety (d = − 0.188, 95% CI − 0.007 to 0.356, z = 2.181, p = 0.029). More research is needed to investigate the impact of psychological variables on assisted reproductive technologies outcomes and moderator influences during assisted reproductive technologies processes.Electronic supplementary materialThe online version of this article (10.1186/s13104-017-3049-z) contains supplementary material, which is available to authorized users.

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“…Seven publications reported on antipsychotics; 43,44,50,62,85,90,97 of these, four reported on antipsychotics as a class (1 compared second-generation antipsychotics to a control, 50 1 compared antipsychotics associated with increased risks of nongestational type 2 diabetes mellitus to control, 97 and 2 separately compared second-generation antipsychotics to a control and first-generation antipsychotics to a control 62 , 85 ), and four focused on specific antipsychotics compared with control. 43, 44, 62 , 90 These publications drew from four cohorts (3 from the National Pregnancy Registry for Atypical Antipsychotics, 43, 44, 50 2 from the U.S. Medicaid Analytic eXtract, 62 , 90 1 from the Taiwan National Health Insurance Research Database and birth certificate registry, 85 and 1 from a cohort based in Australia.…”

Section: Detailed Resultsmentioning

confidence: 99%

Maternal, Fetal, and Child Outcomes of Mental Health Treatments in Women: A Systematic Review of Perinatal Pharmacologic Interventions

Viswanathan¹,

Middleton²,

Stuebe³

et al. 2021

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Background. Untreated maternal mental health disorders can have devastating sequelae for the mother and child. For women who are currently or planning to become pregnant or are breastfeeding, a critical question is whether the benefits of treating psychiatric illness with pharmacologic interventions outweigh the harms for mother and child. Methods. We conducted a systematic review to assess the benefits and harms of pharmacologic interventions compared with placebo, no treatment, or other pharmacologic interventions for pregnant and postpartum women with mental health disorders. We searched four databases and other sources for evidence available from inception through June 5, 2020 and surveilled the literature through March 2, 2021; dually screened the results; and analyzed eligible studies. We included studies of pregnant, postpartum, or reproductive-age women with a new or preexisting diagnosis of a mental health disorder treated with pharmacotherapy; we excluded psychotherapy. Eligible comparators included women with the disorder but no pharmacotherapy or women who discontinued the pharmacotherapy before pregnancy. Results. A total of 164 studies (168 articles) met eligibility criteria. Brexanolone for depression onset in the third trimester or in the postpartum period probably improves depressive symptoms at 30 days (least square mean difference in the Hamilton Rating Scale for Depression, -2.6; p=0.02; N=209) when compared with placebo. Sertraline for postpartum depression may improve response (calculated relative risk [RR], 2.24; 95% confidence interval [CI], 0.95 to 5.24; N=36), remission (calculated RR, 2.51; 95% CI, 0.94 to 6.70; N=36), and depressive symptoms (p-values ranging from 0.01 to 0.05) when compared with placebo. Discontinuing use of mood stabilizers during pregnancy may increase recurrence (adjusted hazard ratio [AHR], 2.2; 95% CI, 1.2 to 4.2; N=89) and reduce time to recurrence of mood disorders (2 vs. 28 weeks, AHR, 12.1; 95% CI, 1.6 to 91; N=26) for bipolar disorder when compared with continued use. Brexanolone for depression onset in the third trimester or in the postpartum period may increase the risk of sedation or somnolence, leading to dose interruption or reduction when compared with placebo (5% vs. 0%). More than 95 percent of studies reporting on harms were observational in design and unable to fully account for confounding. These studies suggested some associations between benzodiazepine exposure before conception and ectopic pregnancy; between specific antidepressants during pregnancy and adverse maternal outcomes such as postpartum hemorrhage, preeclampsia, and spontaneous abortion, and child outcomes such as respiratory issues, low Apgar scores, persistent pulmonary hypertension of the newborn, depression in children, and autism spectrum disorder; between quetiapine or olanzapine and gestational diabetes; and between benzodiazepine and neonatal intensive care admissions. Causality cannot be inferred from these studies. We found insufficient evidence on benefits and harms from comparative effectiveness studies, with one exception: one study suggested a higher risk of overall congenital anomalies (adjusted RR [ARR], 1.85; 95% CI, 1.23 to 2.78; N=2,608) and cardiac anomalies (ARR, 2.25; 95% CI, 1.17 to 4.34; N=2,608) for lithium compared with lamotrigine during first- trimester exposure. Conclusions. Few studies have been conducted in pregnant and postpartum women on the benefits of pharmacotherapy; many studies report on harms but are of low quality. The limited evidence available is consistent with some benefit, and some studies suggested increased adverse events. However, because these studies could not rule out underlying disease severity as the cause of the association, the causal link between the exposure and adverse events is unclear. Patients and clinicians need to make an informed, collaborative decision on treatment choices.

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Effects of depression pharmacotherapy in fertility treatment on conception, birth, and neonatal health: A systematic review

Cited by 12 publications

References 58 publications

Polycystic ovary syndrome and psychiatric disorders: Co-morbidity and heritability in a nationwide Swedish cohort

Polycystic ovary syndrome and psychiatric disorders: Co-morbidity and heritability in a nationwide Swedish cohort

A systematic review and meta-analysis of psychological predictors of successful assisted reproductive technologies

Maternal, Fetal, and Child Outcomes of Mental Health Treatments in Women: A Systematic Review of Perinatal Pharmacologic Interventions

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