Document Detail

Delivery outcome after maternal use of antidepressant drugs in pregnancy: an update using Swedish data.
MedLine Citation:
PMID:  20047705     Owner:  NLM     Status:  MEDLINE    
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.
M Reis; B Källén
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Publication Detail:
Type:  Journal Article     Date:  2010-01-05
Journal Detail:
Title:  Psychological medicine     Volume:  40     ISSN:  1469-8978     ISO Abbreviation:  Psychol Med     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-08-25     Completed Date:  2010-12-03     Revised Date:  2010-12-20    
Medline Journal Info:
Nlm Unique ID:  1254142     Medline TA:  Psychol Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  1723-33     Citation Subset:  IM    
Department of Forensic Genetics and Forensic Toxicology, National Board of Forensic Medicine, Linköping, Sweden.
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MeSH Terms
Abnormalities, Drug-Induced / epidemiology*,  etiology
Antidepressive Agents / adverse effects*
Antidepressive Agents, Second-Generation / adverse effects
Antidepressive Agents, Tricyclic / adverse effects
Birth Weight / drug effects
Cardiovascular Abnormalities / chemically induced,  epidemiology
Confidence Intervals
Gestational Age
Hypospadias / chemically induced,  epidemiology
Infant, Newborn
Maternal Age
Monoamine Oxidase Inhibitors / adverse effects
Odds Ratio
Pregnancy Complications / drug therapy*,  psychology
Pregnancy Outcome* / epidemiology,  psychology
Serotonin Uptake Inhibitors / adverse effects
Sweden / epidemiology
Reg. No./Substance:
0/Antidepressive Agents; 0/Antidepressive Agents, Second-Generation; 0/Antidepressive Agents, Tricyclic; 0/Monoamine Oxidase Inhibitors; 0/Serotonin Uptake Inhibitors
Comment In:
Psychol Med. 2011 Jan;41(1):15-7   [PMID:  20550739 ]

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