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

von freakoutcrazy

by ajog

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.

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