Maternal antidepressant use and adverse outcomes: a cohort study of 228,876 pregnancies
American Journal of Obstetrics and Gynecology, 05/03/2012
Hayes RM et al. – Most women discontinue antidepressant medications prior or during the first trimester of pregnancy. Second trimester antidepressant use is associated with preterm birth, and third trimester SSRI use is associated with infant convulsions.Methods
- Cohort of 228,876 singleton pregnancies covered by Tennessee Medicaid, 1995–2007.
- Of 23,280 pregnant women with antidepressant prescriptions prior to pregnancy, 75% filled none in the second or third trimesters of pregnancy and 10.7% used antidepressants throughout pregnancy.
- Filling 1, 2, and 3+ antidepressants during second trimester was associated with shortened gestational age by 1.7 (1.2– 2.3), 3.7 (2.8– 4.6), and 4.9 (3.9– 5.8) days, controlling for measured confounders.
- Third trimester selective serotonin reuptake inhibitor (SSRI) use was associated with infant convulsions; adjusted odds ratios were 1.4 (0.7–2.8); 2.8 (1.9– 5.5); and 4.9 (2.6–9.5) for filling 1, 2, and 3 prescriptions respectively.