Timing of selective serotonin reuptake inhibitor use and risk for preterm birth and related adverse events: with a consideration of the COVID-19 pandemic period

被引:2
作者
Hwang, Yeon Mi [1 ,2 ]
Roper, Ryan T. [1 ]
Piekos, Samantha N. [1 ]
Enquobahrie, Daniel A. [3 ]
Hebert, Mary F. [4 ]
Paquette, Alison G. [5 ,6 ]
Baloni, Priyanka [7 ]
Price, Nathan D. [1 ,8 ]
Hood, Leroy [1 ,9 ]
Hadlock, Jennifer J. [1 ,10 ]
机构
[1] Inst Syst Biol, Seattle, WA USA
[2] Univ Washington, Mol Engn & Sci Inst, Seattle, WA USA
[3] Univ Washington, Sch Publ Hlth, Dept Epidemiol, Seattle, WA USA
[4] Univ Washington, Sch Pharm, Dept Pharm, Seattle, WA USA
[5] Univ Washington, Sch Med, Dept Pediat, Seattle, WA USA
[6] Seattle Childrens Res Inst, Ctr Dev Biol & Regenerat Med, Seattle, WA USA
[7] Purdue Univ, Sch Hlth Sci, W Lafayette, IN USA
[8] Thorne HealthTech, New York, NY USA
[9] Providence St Joseph Hlth, Renton, WA USA
[10] Inst Syst Biol, 401 Terry Ave N, Seattle, WA 98109 USA
关键词
Preterm birth; infant; low birth weight; small for gestational age; serotonin uptake inhibitors; maternal depression; COVID-19; DEPRESSIVE SYMPTOMS; MATERNAL USE; UNTREATED DEPRESSION; ANTIDEPRESSANT USE; PRENATAL EXPOSURE; PREGNANCY; DELIVERY; METAANALYSIS; OUTCOMES; STRESS;
D O I
10.1080/14767058.2024.2313364
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
ObjectiveThere is uncertainty around the safety of SSRIs for treating depression during pregnancy. Nevertheless, the use of SSRIs has been gradually increasing, especially during the COVID-19 pandemic period. We aimed to (1) characterize maternal depression rate and use of SSRIs in a recent 10-year period, (2) address confounding by indication, as well as socioeconomic and environmental factors, and (3) evaluate associations of the timing of SSRI exposure in pregnancy with risk for preterm birth (PTB), low birthweight (LBW), and small for gestational age (SGA) infants among women with depression before pregnancy.MethodsWe conducted propensity score-adjusted regression to calculate odds ratios (ORs) of PTB, LBW, and SGA. We accounted for maternal/pregnancy characteristics, comorbidity, depression severity, time of delivery, social vulnerability, and rural residence.ResultsThere were 50.3% and 40.3% increases in the prevalence rate of prenatal depression and prenatal SSRI prescription rate during the pandemic. We identified women with depression <= 180 days before pregnancy (n = 8406). Women with no SSRI order during pregnancy (n = 3760) constituted the unexposed group. The late SSRI exposure group consisted of women with an SSRI order after the first trimester (n = 3759). The early-only SSRI exposure group consisted of women with SSRI orders only in the first trimester (n = 887). The late SSRI exposure group had an increased risk of PTB of OR = 1.5 ([1.2,1.8]) and LBW of OR = 1.5 ([1.2,2.0]), relative to the unexposed group. Associations between late SSRI exposure and risk of PTB/LBW were similar among a subsample of patients who delivered during the pandemic.ConclusionsThese findings suggest an association between PTB/LBW and SSRI exposure is dependent on exposure timing during pregnancy. Small for gestational age is not associated with SSRI exposure.
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页数:11
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