Risk of adverse perinatal outcomes among women with pharmacologically treated and untreated depression during pregnancy: A retrospective cohort study

Adhikari, Kamala; Patten, Scott B.; Lee, Sang‐Min; Metcalfe, Amy

doi:10.1111/ppe.12576

Cited by 15 publications

(10 citation statements)

References 34 publications

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“…34 This research group found an independent association with adverse perinatal outcomes for both antidepressant use (70% SSRI) and depression with no antidepressant use. 34 Our research highlights that mood disorder alone may increase the risk for CHD. The impact of substance self-medication, stress and possible pharmacogenetic vulnerabilities needs further investigation in women with a mood disorder.…”

Section: Discussionmentioning

confidence: 90%

“…Although they did not investigate women with a history of a mood disorder without antidepressant use, they did find an increased prevalence of foetal CHD in a small group of women who used SSRI medication in the year before or after pregnancy but not in the first trimester. This differentiation of data is more clearly investigated by Adhikari and colleagues who highlight the importance and potential impact of the underlying mood disorder on perinatal adverse outcomes separate from antidepressant exposure 34 . This research group found an independent association with adverse perinatal outcomes for both antidepressant use (70% SSRI) and depression with no antidepressant use 34 …”

Section: Discussionmentioning

confidence: 98%

“…This differentiation of data is more clearly investigated by Adhikari and colleagues who highlight the importance and potential impact of the underlying mood disorder on perinatal adverse outcomes separate from antidepressant exposure 34 . This research group found an independent association with adverse perinatal outcomes for both antidepressant use (70% SSRI) and depression with no antidepressant use 34 …”

Section: Discussionmentioning

confidence: 98%

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Selective serotonin reuptake inhibitor or serotonin‐norepinephrine reuptake inhibitors and epidemiological characteristics associated with prenatal diagnosis of congenital heart disease

et al. 2020

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Objective Identify early pregnancy associations of congenital heart disease (CHD) in a multiethnic cohort. Methods This retrospective observational cohort study compared the general obstetric population to women who gave birth at a referral centre in Australia between 2012 and 2017, after 20 weeks' of gestation, with a pregnancy affected by CHD. We defined mood disorder and anxiety as a history of self‐reported or medically diagnosed anxiety, depression, postpartum depression or bipolar disorder. Results We compared epidemiological factors between 30 842 general obstetric patients and 470 obstetric patients with a foetus affected by CHD. Multivariate analysis showed independent associations between CHD and use of selective serotonin reuptake inhibitors (SSRIs) or serotonin‐norepinephrine reuptake inhibitors (SNRIs) in the first trimester (relative risk [RR] 4.14, 95% CI 2.58‐6.65), history of anxiety or mood disorder with no SSRI/SNRI first trimester (RR 2.20, 95% CI 1.77‐2.74), folate and/or pregnancy multivitamin use in the first trimester (RR 0.69, 95% CI 0.55‐0.87) and increased risk with maternal age >40 years (RR 2.30, 95% CI 1.57‐3.38). Conclusions Our data show maternal mood disorders with and without SSRI or SNRI use, maternal age >40 years and lack of multivitamin/folate use to be independently associated with CHD in pregnancy.

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 98%

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Selective serotonin reuptake inhibitor or serotonin‐norepinephrine reuptake inhibitors and epidemiological characteristics associated with prenatal diagnosis of congenital heart disease

et al. 2020

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“…The women who discontinue their medication have a higher risk of relapsing during pregnancy compared with women who maintained their antidepressant medication (4,78,82). Discontinuation of antidepressant medication during pregnancy leads to treatment resumption in 12-57% of the cases before childbirth (75,(83)(84)(85). Factors associated with treatment resumption for pregnant women in Sweden are: a greater burden of pre-pregnancy psychiatric illnesses, multipara, higher educational level and have been born in the Nordic countries or the EU.…”

Section: Antidepressant Medication During Pregnancymentioning

confidence: 99%

Drug use during pregnancy with focus on antidepressants

Wolgast

2020

Linköping University Medical Dissertations

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Background: More than half of pregnant women use at least one prescribed medication during pregnancy, and almost all pregnant women use some kind of over-the-counter medication. Depression is one of the most common diseases in the world today, also during the peripartum period. The prevalence of pregnant women using antidepressant medication is increasing. General knowledge about the use of medication during pregnancy needs to improve. The overall aim of the studies on which this thesis is based is therefore to examine different aspects of medication use during pregnancy, with a focus on antidepressants. Material and methods:Study I was a questionnaire study where 850 pregnant women were asked about their perceptions on medication use during pregnancy. In Study II, plasma samples from 200 women were obtained at gestational weeks 10-12 and 25, and screened for drugs. The results of the analysis were compared with medication use noted in antenatal medical care records. Study III was a national register-based cohort study including 262,329 pregnant women, and their first child born in 2012-2015. Maternal obstetric and neonatal outcomes were studied in three groups: women diagnosed with depression and who had redeemed an antidepressant before becoming pregnant and women who were diagnosed with depression and who had redeemed an antidepressant both before and during pregnancy, were compared with each other and with women who had neither been diagnosed with depression nor been prescribed antidepressants. Study IV was a pharmacokinetic study that included 81 pregnant women with ongoing antidepressant medical treatment. Antidepressant drug and metabolite concentrations were measured throughout pregnancy. Participants were genotyped for enzymes involved in antidepressant drug metabolism, i.e. CYP2D6 and CYP2C19. Results and conclusions:The majority of pregnant women in our study considered the use of medication during pregnancy as either "probably harmful" or "harmful", and this perception was associated with non-use of medication. The women had high confidence in health care professionals when seeking advice about medication.

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“…Therefore, even if the exact gestational age when dose changed is unknown, the results will not be biased insofar as women fall into the correct group of women with similar antidepressant use. On the other hand, a more simplified analysis may miss important nuances, as a previous study using a dichotomous definition of antidepressant use with a minimum threshold of adherence throughout pregnancy did not find an association between antidepressant use and maternal morbidity …”

mentioning

confidence: 99%