UMMS Affiliation

Department of Quantitative Health Sciences

Publication Date

2017-10-01

Document Type

Article

Disciplines

Female Urogenital Diseases and Pregnancy Complications | Maternal and Child Health | Obstetrics and Gynecology | Pharmacology, Toxicology and Environmental Health | Pharmacy and Pharmaceutical Sciences | Women's Health

Abstract

PURPOSE: To describe the risk of early- and late-onset preeclampsia across pregnancies exposed to antidepressants and to evaluate the impact of timing and length of gestational exposure to antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), on preeclampsia.

METHODS: The Norwegian Mother and Child Cohort, a prospective population-based study, and the Medical Birth Registry of Norway provided information on antidepressant exposure, depression, and anxiety symptoms in pregnancy, preeclampsia diagnoses, and important covariates. Within a pregnancy cohort of depressed women, we compared the risk of late-onset preeclampsia between SSRI-exposed and nonmedicated pregnancies using marginal structural models (weighted) and modified Poisson regression models.

RESULTS: Of the 5887 pregnancies included, 11.1% were exposed at any time before week 34 to SSRIs, 1.3% to serotonin-norepinephrine reuptake inhibitors, 0.4% to tricyclic antidepressants, and 0.5% to other antidepressants. The risks of early- and late-onset preeclampsia by exposure status in pregnancy were 0.3% and 3.6% (nonmedicated), 0.4% and 3.7% (SSRIs), 1.5% and 4.1% (serotonin-norepinephrine reuptake inhibitors), and 7.1% and 10.0% (tricyclic antidepressants). Compared with nonmedicated pregnancies, SSRI-exposed in mid and late gestation had adjusted relative risks for late-onset mild preeclampsia of 0.76 (95% confidence interval, 0.38-1.53) and 1.56 (0.71-3.44) (weighted models), respectively. There was no association between SSRI exposure in pregnancy and severe late-onset preeclampsia.

CONCLUSIONS: We have provided evidence that SSRI use in early and midpregnancy does not substantially increase the risk of late-onset preeclampsia.

Keywords

MoBa, SSRI, The Norwegian Mother and Child Cohort Study, antidepressant, pharmacoepidemiology, preeclampsia, pregnancy

Rights and Permissions

© 2017 The Authors. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

DOI of Published Version

10.1002/pds.4286

Source

Pharmacoepidemiol Drug Saf. 2017 Oct;26(10):1266-1276. doi: 10.1002/pds.4286. Epub 2017 Aug 16. Link to article on publisher's site

Journal/Book/Conference Title

Pharmacoepidemiology and drug safety

Related Resources

Link to Article in PubMed

PubMed ID

28815791

Creative Commons License

Creative Commons Attribution-Noncommercial 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License

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