Casey R Tak1,2, Kathleen M Job3, Katie Schoen-Gentry4, Sarah C Campbell5,6, Patrick Carroll7,8, Maged Costantine9, Diana Brixner1,10, Angela K Birnbaum11, Catherine M T Sherwin12,13,14. 1. Pharmacotherapy Outcomes Research Center, Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, UT, USA. 2. Clinical Trials Office, Department of Pediatrics, University of Utah, Salt Lake City, UT, USA. 3. Division of Clinical Pharmacology, Department of Pediatrics, University of Utah of Medicine, SLC, Utah 295 Chipeta Way, Salt Lake City, UT, 84108, USA. 4. Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT, USA. 5. Nelson Laboratories, Salt Lake City, UT, USA. 6. Department of Pharmacology and Toxicology, College of Pharmacy, University of Utah Salt Lake City, Salt Lake City, UT, USA. 7. Women and Newborn Clinical Program, Department of Pediatrics, Dixie Regional Medical Center, Intermountain Healthcare, St. George, UT, USA. 8. Neonatal Services, Dixie Regional Medical Center, 544 East 400 South, St George, UT, 84770, USA. 9. Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, TX, USA. 10. Program in Personalized Health, Health Sciences Center, University of Utah, Salt Lake City, UT, USA. 11. Department of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota, Minneapolis, MN, USA. 12. Clinical Trials Office, Department of Pediatrics, University of Utah, Salt Lake City, UT, USA. Catherine.sherwin@hsc.utah.edu. 13. Division of Clinical Pharmacology, Department of Pediatrics, University of Utah of Medicine, SLC, Utah 295 Chipeta Way, Salt Lake City, UT, 84108, USA. Catherine.sherwin@hsc.utah.edu. 14. Department of Pharmacology and Toxicology, College of Pharmacy, University of Utah Salt Lake City, Salt Lake City, UT, USA. Catherine.sherwin@hsc.utah.edu.
Abstract
INTRODUCTION: Concerns with prescription antidepressant use in pregnant women have instigated the examination of potential associations between fetal exposure to antidepressant medication and outcomes including preterm delivery, congenital malformations, perinatal and post-natal adverse events, persistent pulmonary hypertension, and mortality. The retrospective cohort model is an often utilized study design. The objective of this review is to evaluate the literature on antidepressant use in pregnancy conducted as retrospective cohorts in national/regional medical, or claims databases that assess neonatal and infant outcomes for agreement between studies, ultimately providing a methodological and outcomes summary for future scientific endeavors. METHODS: PubMed was searched for literature relating to antidepressant use and infant outcomes from the earliest available date through July 15, 2016. Studies with a retrospective cohort design and conducted in national/regional medical or claims databases were included. Searched outcomes included preterm delivery, congenital malformations, low birth weight, small for gestational age, persistent pulmonary hypertension of the newborn, and other select adverse events comprising low Apgar score (5 min), convulsions/seizures, respiratory distress/problems, fetal mortality, and infant mortality. RESULTS: Of the 784 studies identified, 36 retrospective cohort studies met eligibility criteria. An increase in preterm delivery and respiratory distress/problems and no increase in congenital malformation or fetal and infant death were associated with prenatal use of prescription antidepressants by majority consensus (at least 2/3 [67%] of studies). CONCLUSIONS: While consensus indicates that perinatal prescription antidepressant use has consequences for the fetus and infant, there are notable inconsistencies in the literature. More investigations that address prenatal exposure to depression and other important covariates are needed.
INTRODUCTION: Concerns with prescription antidepressant use in pregnant women have instigated the examination of potential associations between fetal exposure to antidepressant medication and outcomes including preterm delivery, congenital malformations, perinatal and post-natal adverse events, persistent pulmonary hypertension, and mortality. The retrospective cohort model is an often utilized study design. The objective of this review is to evaluate the literature on antidepressant use in pregnancy conducted as retrospective cohorts in national/regional medical, or claims databases that assess neonatal and infant outcomes for agreement between studies, ultimately providing a methodological and outcomes summary for future scientific endeavors. METHODS: PubMed was searched for literature relating to antidepressant use and infant outcomes from the earliest available date through July 15, 2016. Studies with a retrospective cohort design and conducted in national/regional medical or claims databases were included. Searched outcomes included preterm delivery, congenital malformations, low birth weight, small for gestational age, persistent pulmonary hypertension of the newborn, and other select adverse events comprising low Apgar score (5 min), convulsions/seizures, respiratory distress/problems, fetal mortality, and infant mortality. RESULTS: Of the 784 studies identified, 36 retrospective cohort studies met eligibility criteria. An increase in preterm delivery and respiratory distress/problems and no increase in congenital malformation or fetal and infantdeath were associated with prenatal use of prescription antidepressants by majority consensus (at least 2/3 [67%] of studies). CONCLUSIONS: While consensus indicates that perinatal prescription antidepressant use has consequences for the fetus and infant, there are notable inconsistencies in the literature. More investigations that address prenatal exposure to depression and other important covariates are needed.
Authors: Susan E Andrade; Heather McPhillips; David Loren; Marsha A Raebel; Kimberly Lane; James Livingston; Denise M Boudreau; David H Smith; Robert L Davis; Mary E Willy; Richard Platt Journal: Pharmacoepidemiol Drug Saf Date: 2009-03 Impact factor: 2.890
Authors: Andrea V Margulis; Adel Abou-Ali; Marian M Strazzeri; Yulan Ding; Fatmatta Kuyateh; Eric Y Frimpong; Mark S Levenson; Tarek A Hammad Journal: Pharmacoepidemiol Drug Saf Date: 2013-06-03 Impact factor: 2.890
Authors: Merja K Laine; Senja Masalin; Kristiina Rönö; Hannu Kautiainen; Mika Gissler; Pirjo Pennanen; Johan G Eriksson Journal: Ann Med Date: 2018-11-19 Impact factor: 4.709