Pregnancy outcome of women exposed to bupropion during pregnancy: A prospective comparative study

Chan, Biu; Koren, Gideon; Fayez, Ibrahim; Kalra, Sanjog; Voyer-Lavigne, Sharon; Boshier, Andrew; Shakir, Saad; Einarson, Adrienne

doi:10.1016/j.ajog.2004.09.027

Cited by 198 publications

(129 citation statements)

References 10 publications

Supporting

Mentioning

119

Contrasting

Unclassified

Order By: Relevance

“…12 Most of the above studies had limitations such as insufficient power; inefficient study design; potential misclassification of study outcome or exposure owing to maternal recall; lack of complete information on exposure including type, timing and dosage of antidepressant; and the inability to fully address potential confounders, especially indication for use of antidepressants. 8,11 Nevertheless, our findings are similar to those of Einarson and colleagues, who showed that overall antidepressant use during early gestation increased the risk of spontaneous abortion by 63%. 18 Much remains unclear with regard to the exact mechanism of action, although it has been suggested that the effect of selective serotonin reuptake inhibitors on spontaneous abortion is probably mediated by a serotonergic mechanism.…”

Section: 12supporting

confidence: 77%

“…7 In another study, involving 136 women exposed to bupropion early in their pregnancy, Chun-Fai-Chan and colleagues reported more spontaneous abortions in the bupropion group than in the comparison groups. 8 In contrast, Chambers and colleagues observed no statistically significant difference in the occurrence of spontaneous abortion between women taking fluoxetine during pregnancy and pregnant women not taking the medication. 25 Similarly, Kulin and colleagues observed no significant association between the use of antidepressants during pregnancy and the risk of spontaneous abortion among 92 women who received fluvoxamine in combination with other antidepressants compared with 267 pregnant women not taking antidepressants.…”

Section: Discussionmentioning

confidence: 92%

“…4 One out of four pregnancies ends in a clinically apparent spontaneous abortion. 5,6 The majority of previous studies of antidepressants did not look at spontaneous abortion as a primary outcome, [7][8][9] had small samples and therefore lacked statistical power, [7][8][9][10] or had inherent biases owing to unmeasured confounders. 11 Furthermore, the risk of spontaneous abortion associated with specific antidepressant classes, types and doses has not been adequately studied.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Use of antidepressants during pregnancy and the risk of spontaneous abortion

Nakhai-Pour¹,

Broy²,

Bérard³

2010

Canadian Medical Association Journal

136

View full text Add to dashboard Cite

; Centre hospitalier universitaire Sainte-Justine (Nakhai-Pour, Broy, Bérard), University of Montreal, Montréal, Que.; École nationale de la statistique et de l'analyse de l'information (Broy), Rennes, France; and the Ministry of Health and Medical Education (Nakhai-Pour), Tehran, Iran CMAJ 2010. DOI:10.1503/cmaj.091208 Background:The risk of relapse of depression or the diagnosis of some other psychiatric disorders during pregnancy necessitates the use of antidepressants despite possible adverse effects. Whether such use increases the risk of spontaneous abortion is still being debated. We evaluated the risk of spontaneous abortion in relation to the use of antidepressants during pregnancy. Methods:Using a nested case-control study design, we obtained data from the Quebec Pregnancy Registry for 5124 women who had a clinically detected spontaneous abortion. For each case, we randomly selected 10 controls from the remaining women in the registry who were matched by the case's index date (date of spontaneous abortion) and gestational age at the time of spontaneous abortion. Use of antidepressants was defined by filled prescriptions and was compared with nonuse. We also studied the classes, types and doses of antidepressants.Results: A total of 284 (5.5%) of the women who had a spontaneous abortion had at least one prescription for an anti depressant filled during the pregnancy, as compared with 1401 (2.7%) of the matched controls (odds ratio [OR] 2.09, 95% confidence interval [CI] 1.83-2.38). After adjustment for potential confounders, we found that the use of antidepressants during pregnancy was associated with an increased risk of spontaneous abortion (OR 1.68, 95%CI 1.38-2.06). Stratified analyses showed that use of selective serotonin reuptake inhibitors alone (OR 1.61, 95% CI 1.28-2.04), serotonin-norepinephrine reuptake inhibitors alone (OR 2.11, 95% CI 1.34-3.30) and combined use of antidepressants from different classes (OR 3.51, were associated with an increased risk of spontaneous abortion. When we looked at antidepressant use by type versus no use, paroxetine use alone (OR 1.75, 95% CI 1.31-2.34) and venlafaxine use alone (OR 2.11, 95% CI 1.34-3.30) were associated with an increased risk of spontaneous abortion. Interpretation:The use of antidepressants, especially paroxetine, venlafaxine or the combined use of different classes of antidepressants, during pregnancy was associated with an increased risk of spontaneous abortion. Abstract

show abstract

Section: 12supporting

confidence: 77%

Section: Discussionmentioning

confidence: 92%

mentioning

confidence: 99%

See 1 more Smart Citation

Use of antidepressants during pregnancy and the risk of spontaneous abortion

Nakhai-Pour¹,

Broy²,

Bérard³

2010

Canadian Medical Association Journal

136

View full text Add to dashboard Cite

show abstract

“…Among atypical antidepressants, buproprion and maprotiline are classified as Category B. According to the prospectively obtained data from the manufacturer and the prospective study [20], bupropion does not increase the risk of developing abnormalities. Trazodone and venlafaxine are Category C drugs.…”

Section: Drug Treatment During Pregnancymentioning

confidence: 99%

Therapeutic Approaches for Depression During Pregnancy and Lactation

Kim¹

2014

J Preg Child Health

View full text Add to dashboard Cite

“…SSRIs have only been associated with cardiac abnormalities in retrospective studies. Some case reports and epidemiological studies for other SSRIs and another group of antidepressants also did not find any association for increased risk (27,(29)(30)(31) There is a limited amount of data regarding the longterm effects temperament, behavior, reactivity, mood, distractibility, and activity level among groups when followed through early childhood. No difference has been detected in behavioral or cognitive development in children exposed to Fluoxetine, TCAs or without medication, in terms of IQ, language, temperament, behavior, reactivity, mood, distractibility, and activity level among groups when followed through early childhood (27,32,33).…”

Section: During Pregnancymentioning

confidence: 99%

A challenging issue: Should medications be prescribed to pregnant and depressed women?

Oral¹,

Güleç²

2011

JMOOD

View full text Add to dashboard Cite

ÖZET:Dikkat çekici bir konu: Hamile ve depresyondaki kadınlara ilaç önerilmeli mi?Erkeklere kıyasla kadınlar daha fazla depresyon yaygınlık oranlarına sahiptir ve özellkle doğurganlık çağında depresyona daha da duyarlıdırlar. Depresyon oranları gebelik dönemindeki kadınlar için %20'lere kadar ulaşabilir. Aslında kadınları tedavi eden bir klinisyenin, kendisini annenin ve bebeğin gelişiminin korunması için en uygun yöntemi seçmeye çalışırken bulması oldukça muhtemeldir. Emniyet konuları ve doğumla ilgili olumsuz sonuçlar gebelikte antidepresan kullanımı ile ilgili başlıca endişe alanlarıdır. Diğer taraftan, tedavi edilmemiş depresyon da anne ve bebek için sağlık komplikasyonlarına yol açma potansiyeline sahiptir. Ancak gebelikte antidepresan kullanımının muhtemel yan etkilerinin daha fazla vurgulandığı ama tedavi edilmemiş depresyonun o kadar önemsenmediği aşikardır. Halihazırdaki çalışmalar gebelik sırasında antidepresan kullanımının emniyetli olup olmadığına dair çelişkili sonuçlar ortaya koymaktadır dolayısıyla da mevcut verilerin yorumlanması çok dikkatli bir şekilde yapılmalıdır. Ebeveynlerle birlikte karar verirken her iki seçeneğin de riskleri ve faydaları göz önüne alınmalıdır. A challenging issue: Should medications be prescribed to pregnant and depressed women?Women have higher prevalence rates of depression than men and they are particularly vulnerable to depression in childbearing years. The rates of depression can reach up to 20% of all women during pregnancy. Actually, physicians who treat women are likely to find themselves trying to choose the best option for protection of the mother and for the development of her child. Safety issues and negative birth outcomes are matters of concern with antidepressant use during pregnancy. Otherwise, untreated depression also has potential to cause health complications for both mother and infant. It is obvious that possible adverse effects of antidepressant use during pregnancy are more emphasized but adverse outcomes of untreated depression are underrated. Currently, studies exhibit conflicting results about antidepressant safety in pregnancy period so current data must be cautiously interpreted. The risks and benefits of both options must be taken into account in decisionmaking process with families.

show abstract

Pregnancy outcome of women exposed to bupropion during pregnancy: A prospective comparative study

Cited by 198 publications

References 10 publications

Use of antidepressants during pregnancy and the risk of spontaneous abortion

Use of antidepressants during pregnancy and the risk of spontaneous abortion

Therapeutic Approaches for Depression During Pregnancy and Lactation

A challenging issue: Should medications be prescribed to pregnant and depressed women?

Contact Info

Product

Resources

About