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Delivery outcome after maternal use of antidepressant drugs in pregnancy: an update using Swedish data

Reis, M and Källén, Bengt LU (2010) In Psychological Medicine 40(10). p.1723-1733
Abstract
Background. Concerns have been expressed about possible adverse effects of the use of antidepressant medication during pregnancy, including risk for neonatal pathology and the presence of congenital malformations. Method. Data from the Swedish Medical Birth Register (MBR) from 1 July 1995 up to 2007 were used to identify women who reported the use of antidepressants in early pregnancy or were prescribed antidepressants during pregnancy by antenatal care : a total of 14 821 women with 15 017 infants. Maternal characteristics, maternal delivery diagnoses, infant neonatal diagnoses and the presence of congenital malformations were compared with all other women who gave birth, using the Mantel-Haenszel technique and with adjustments for... (More)
Background. Concerns have been expressed about possible adverse effects of the use of antidepressant medication during pregnancy, including risk for neonatal pathology and the presence of congenital malformations. Method. Data from the Swedish Medical Birth Register (MBR) from 1 July 1995 up to 2007 were used to identify women who reported the use of antidepressants in early pregnancy or were prescribed antidepressants during pregnancy by antenatal care : a total of 14 821 women with 15 017 infants. Maternal characteristics, maternal delivery diagnoses, infant neonatal diagnoses and the presence of congenital malformations were compared with all other women who gave birth, using the Mantel-Haenszel technique and with adjustments for certain characteristics. Results. There was an association between antidepressant treatment and pre-existing diabetes and chronic hypertension but also with many pregnancy complications. Rates of induced delivery and caesarean section were increased. The preterm birth rate was increased but not that of intrauterine growth retardation. Neonatal complications were common, notably after tricyclic antidepressant (TCA) use. An increased risk of persistent pulmonary hypertension of the newborn (PPHN) was verified. The congenital malformation rate was increased after TCAs. An association between use of paroxetine and congenital heart defects was verified and a similar effect on hypospadias was seen. Conclusions. Women using antidepressants during pregnancy and their newborns have increased pathology. It is not clear how much of this is due to drug use or underlying pathology. Use of TCAs was found to carry a higher risk than other antidepressants and paroxetine seems to be associated with a specific teratogenic property. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
neonatal symptoms, Antidepressant drugs, congenital malformations, pregnancy
in
Psychological Medicine
volume
40
issue
10
pages
1723 - 1733
publisher
Cambridge University Press
external identifiers
  • wos:000281408700014
  • scopus:77957168545
ISSN
1469-8978
DOI
10.1017/S0033291709992194
language
English
LU publication?
yes
id
0b3079af-3c94-4604-8770-cea40d59aa4a (old id 1672187)
date added to LUP
2010-09-21 15:27:57
date last changed
2018-06-17 03:02:29
@article{0b3079af-3c94-4604-8770-cea40d59aa4a,
  abstract     = {Background. Concerns have been expressed about possible adverse effects of the use of antidepressant medication during pregnancy, including risk for neonatal pathology and the presence of congenital malformations. Method. Data from the Swedish Medical Birth Register (MBR) from 1 July 1995 up to 2007 were used to identify women who reported the use of antidepressants in early pregnancy or were prescribed antidepressants during pregnancy by antenatal care : a total of 14 821 women with 15 017 infants. Maternal characteristics, maternal delivery diagnoses, infant neonatal diagnoses and the presence of congenital malformations were compared with all other women who gave birth, using the Mantel-Haenszel technique and with adjustments for certain characteristics. Results. There was an association between antidepressant treatment and pre-existing diabetes and chronic hypertension but also with many pregnancy complications. Rates of induced delivery and caesarean section were increased. The preterm birth rate was increased but not that of intrauterine growth retardation. Neonatal complications were common, notably after tricyclic antidepressant (TCA) use. An increased risk of persistent pulmonary hypertension of the newborn (PPHN) was verified. The congenital malformation rate was increased after TCAs. An association between use of paroxetine and congenital heart defects was verified and a similar effect on hypospadias was seen. Conclusions. Women using antidepressants during pregnancy and their newborns have increased pathology. It is not clear how much of this is due to drug use or underlying pathology. Use of TCAs was found to carry a higher risk than other antidepressants and paroxetine seems to be associated with a specific teratogenic property.},
  author       = {Reis, M and Källén, Bengt},
  issn         = {1469-8978},
  keyword      = {neonatal symptoms,Antidepressant drugs,congenital malformations,pregnancy},
  language     = {eng},
  number       = {10},
  pages        = {1723--1733},
  publisher    = {Cambridge University Press},
  series       = {Psychological Medicine},
  title        = {Delivery outcome after maternal use of antidepressant drugs in pregnancy: an update using Swedish data},
  url          = {http://dx.doi.org/10.1017/S0033291709992194},
  volume       = {40},
  year         = {2010},
}