Elizabeth Wall-Wieler1, Thalia K Robakis2, Carolyn E Cesta3, Reem Masarwa4, Deirdre J Lyell5, Can Liu1, Robert W Platt4,6, Suzan L Carmichael1,5. 1. Department of Pediatrics, 6429Stanford University School of Medicine, CA, USA. 2. Department of Psychiatry, 5925Icahn School of Medicine at Mount Sinai, NY, USA. 3. Centre for Pharmacoepidemiology, Department of Medicine, 27106Karolinska Institute, Solna, Sweden. 4. Department of Epidemiology, Biostatistics and Occupational Health, 5620McGill University, Montreal, Quebec, Canada. 5. Department of Obstetrics & Gynecology, 6429Stanford University School of Medicine, CA, USA. 6. Department of Pediatrics, 5620McGill University, Montreal, Quebec, Canada.
Abstract
OBJECTIVE: To compare the risk of ectopic pregnancy among women with and women without antidepressant prescriptions around conception and examine whether this risk differs by prepregnancy depression status. METHODS: We conducted a cohort study of all pregnancies between November 1, 2008, and September 30, 2015, identified in the nationwide (American) IBM® MarketScan® Databases. At least one day's supply of antidepressants in the 3 weeks after a woman's last menstrual period defined active antidepressant use around conception. At least one depression diagnosis in the year before the last menstrual period defined prepregnancy depression. Relative risk (RR) of ectopic pregnancy was estimated using unadjusted and inverse probability of treatment (IPT)-weighted log-binomial models. RESULTS: Of the 1,703,245 pregnancies, 106,788 (6.3%) women had a prepregnancy depression diagnosis. Among women with a depression diagnosis, 40,287 (37.7%) had an active antidepressant prescription around conception; the IPT-weighted risk of ectopic pregnancy was similar among women who did and did not fill an antidepressant prescription around conception (IPT-weighted RR = 1.01; 95% CI, 0.93 to 1.10). Overall, the risk of ectopic pregnancy was higher among women who had a prepregnancy depression diagnosis than women who did not have a prepregnancy depression diagnosis (IPT-weighted RR = 1.09; 95% CI, 1.04 to 1.15). CONCLUSIONS: This study's findings suggest that women who have a prepregnancy depression diagnosis are at a slightly increased risk of ectopic pregnancy, and among women who have a prepregnancy depression diagnosis, the use of antidepressants around conception does not increase the risk of ectopic pregnancy.
OBJECTIVE: To compare the risk of ectopic pregnancy among women with and women without antidepressant prescriptions around conception and examine whether this risk differs by prepregnancy depression status. METHODS: We conducted a cohort study of all pregnancies between November 1, 2008, and September 30, 2015, identified in the nationwide (American) IBM® MarketScan® Databases. At least one day's supply of antidepressants in the 3 weeks after a woman's last menstrual period defined active antidepressant use around conception. At least one depression diagnosis in the year before the last menstrual period defined prepregnancy depression. Relative risk (RR) of ectopic pregnancy was estimated using unadjusted and inverse probability of treatment (IPT)-weighted log-binomial models. RESULTS: Of the 1,703,245 pregnancies, 106,788 (6.3%) women had a prepregnancy depression diagnosis. Among women with a depression diagnosis, 40,287 (37.7%) had an active antidepressant prescription around conception; the IPT-weighted risk of ectopic pregnancy was similar among women who did and did not fill an antidepressant prescription around conception (IPT-weighted RR = 1.01; 95% CI, 0.93 to 1.10). Overall, the risk of ectopic pregnancy was higher among women who had a prepregnancy depression diagnosis than women who did not have a prepregnancy depression diagnosis (IPT-weighted RR = 1.09; 95% CI, 1.04 to 1.15). CONCLUSIONS: This study's findings suggest that women who have a prepregnancy depression diagnosis are at a slightly increased risk of ectopic pregnancy, and among women who have a prepregnancy depression diagnosis, the use of antidepressants around conception does not increase the risk of ectopic pregnancy.
Authors: Sophie Grigoriadis; Emily H VonderPorten; Lana Mamisashvili; Allison Eady; George Tomlinson; Cindy-Lee Dennis; Gideon Koren; Meir Steiner; Patricia Mousmanis; Amy Cheung; Lori E Ross Journal: J Clin Psychiatry Date: 2013-04 Impact factor: 4.384
Authors: Sebastian Schneeweiss; Jeremy A Rassen; Robert J Glynn; Jerry Avorn; Helen Mogun; M Alan Brookhart Journal: Epidemiology Date: 2009-07 Impact factor: 4.822