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Am J Obstet Gynecol. 2012 Jul;207(1):49.e1-9. doi: 10.1016/j.ajog.2012.04.028. Epub 2012 Apr 30.

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

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  • 1Informatics Center, School of Medicine, Vanderbilt University, Nashville, TN, USA.

Erratum in

  • Am J Obstet Gynecol. 2013 Apr;208(4):326.

Abstract

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.

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PMID:
22727349
[PubMed - indexed for MEDLINE]
PMCID:
PMC3567615
Free PMC Article
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