Maternal antidepressant use and adverse outcomes: a cohort study of 228,876 pregnancies.

Hayes RM, Wu P, Shelton RC, Cooper WO, Dupont WD, Mitchel E, Hartert TV
Am J Obstet Gynecol. 2012 207 (1): 49.e1-9

PMID: 22727349 · PMCID: PMC3567615 · DOI:10.1016/j.ajog.2012.04.028

OBJECTIVE - The purpose of this study was to describe antidepressant medication use patterns during pregnancy and pregnancy outcomes.

STUDY DESIGN - We evaluated a cohort of 228,876 singleton pregnancies that were covered by Tennessee Medicaid, 1995-2007.

RESULTS - Of 23,280 pregnant women with antidepressant prescriptions before pregnancy, 75% of them filled none in the second or third trimesters of pregnancy, and 10.7% of them used antidepressants throughout pregnancy. Filling 1, 2, and ≥3 antidepressant prescriptions during the second trimester was associated with shortened gestational age by 1.7 (95% confidence interval [CI], 1.2-2.3), 3.7 (95% CI, 2.8-4.6), and 4.9 (95% CI, 3.9-5.8) days, when controlled for measured confounders. Third-trimester selective serotonin reuptake inhibitor use was associated with infant convulsions; adjusted odds ratios were 1.4 (95% CI, 0.7-2.8); 2.8 (95% CI, 1.9-5.5); and 4.9 (95% CI, 2.6-9.5) for filling 1, 2, and ≥3 prescriptions, respectively.

CONCLUSION - Most women discontinue antidepressant medications before or during the first trimester of pregnancy. Second-trimester antidepressant use is associated with preterm birth, and third-trimester selective serotonin reuptake inhibitor use is associated with infant convulsions.

Copyright © 2012 Mosby, Inc. All rights reserved.

MeSH Terms (23)

Adult Antidepressive Agents Cohort Studies Depression Drug Utilization Female Humans Infant, Low Birth Weight Infant, Newborn Logistic Models Medicaid Multivariate Analysis Obstetric Labor, Premature Pregnancy Pregnancy Complications Pregnancy Outcome Premature Birth Respiratory Distress Syndrome, Newborn Retrospective Studies Seizures Serotonin Uptake Inhibitors Tennessee United States

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