Department of Quantitative Health Sciences
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
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.
MoBa, SSRI, The Norwegian Mother and Child Cohort Study, antidepressant, pharmacoepidemiology, preeclampsia, pregnancy
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© 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
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
Pharmacoepidemiology and drug safety
Lupattelli, Angela; Wood, Mollie; Lapane, Kate L.; Spigset, Olav; and Nordeng, Hedvig, "Risk of preeclampsia after gestational exposure to selective serotonin reuptake inhibitors and other antidepressants: A study from The Norwegian Mother and Child Cohort Study" (2017). Open Access Articles. 3239.
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License
Female Urogenital Diseases and Pregnancy Complications Commons, Maternal and Child Health Commons, Obstetrics and Gynecology Commons, Pharmacology, Toxicology and Environmental Health Commons, Pharmacy and Pharmaceutical Sciences Commons, Women's Health Commons