Depression drug treatment outcomes in pregnancy and the postpartum period: a systematic review and meta-analysis. McDonagh, M. S., Matthews, A., Phillipi, C., Romm, J., Peterson, K., Thakurta, S., & Guise, J. M. Obstetrics and gynecology, 124(3):526–534, 2014. Publisher: Obstet Gynecol![Depression drug treatment outcomes in pregnancy and the postpartum period: a systematic review and meta-analysis [link]](https://bibbase.org/img/filetypes/link.svg "link")
Paper doi abstract bibtex OBJECTIVE: To evaluate the comparative benefits and harms in both mother and child of antidepressant treatment for depression in pregnant or postpartum women. DATA SOURCES: MEDLINE, the Cochrane Library, CINAHL, Scopus, ClinicalTrials.gov (inception to July 2013), manufacturers, and reference lists. METHODS OF STUDY SELECTION: Two reviewers independently selected studies of pregnant women with depression comparing antidepressants with each other, placebo or no treatment, or nondrug treatments. Studies making comparisons among women taking antidepressants for any reason and those not taking antidepressants (depression status unknown) were used to fill gaps in the evidence. TABULATION, INTEGRATION, AND RESULTS: Dual study data extraction and quality assessment were used. Six randomized controlled trials and 15 observational studies provided evidence. Low-strength evidence suggested neonates of pregnant women with depression taking selective serotonin reuptake inhibitors had higher risk of respiratory distress than did neonates of untreated women (13.9% compared with 7.8%; P\textless001) but no difference in risk of neonatal convulsions (0.14% compared with 0.11%; P=.64) or preterm birth (17% compared with 10%; P=.07). Indirect evidence from studies of pregnant women receiving antidepressants for mixed or unreported reasons compared with pregnant women not taking antidepressants (depression status unknown) suggested future research should focus on congenital anomalies and autism spectrum and attention deficit disorders in the child. In postpartum depression, low-strength evidence suggested symptom response was not improved when sertraline was added to psychotherapy or when cognitive-behavioral therapy was added to paroxetine. Evidence was insufficient for other outcomes, including depression symptoms, functional capacity, breastfeeding, and infant and child development. A serious limitation is the lack of study populations of exclusively depressed pregnant and postpartum women. CONCLUSION: Evidence about the comparative benefits and harms of pharmacologic treatment of depression in pregnant and postpartum women was largely inadequate to allow informed decisions about treatment. Considering the prevalence of depression, filling this gap is essential.
@article{mcdonagh_depression_2014,
title = {Depression drug treatment outcomes in pregnancy and the postpartum period: a systematic review and meta-analysis},
volume = {124},
issn = {1873-233X},
url = {https://pubmed.ncbi.nlm.nih.gov/25004304/},
doi = {10.1097/AOG.0000000000000410},
abstract = {OBJECTIVE: To evaluate the comparative benefits and harms in both mother and child of antidepressant treatment for depression in pregnant or postpartum women. DATA SOURCES: MEDLINE, the Cochrane Library, CINAHL, Scopus, ClinicalTrials.gov (inception to July 2013), manufacturers, and reference lists. METHODS OF STUDY SELECTION: Two reviewers independently selected studies of pregnant women with depression comparing antidepressants with each other, placebo or no treatment, or nondrug treatments. Studies making comparisons among women taking antidepressants for any reason and those not taking antidepressants (depression status unknown) were used to fill gaps in the evidence. TABULATION, INTEGRATION, AND RESULTS: Dual study data extraction and quality assessment were used. Six randomized controlled trials and 15 observational studies provided evidence. Low-strength evidence suggested neonates of pregnant women with depression taking selective serotonin reuptake inhibitors had higher risk of respiratory distress than did neonates of untreated women (13.9\% compared with 7.8\%; P{\textless}001) but no difference in risk of neonatal convulsions (0.14\% compared with 0.11\%; P=.64) or preterm birth (17\% compared with 10\%; P=.07). Indirect evidence from studies of pregnant women receiving antidepressants for mixed or unreported reasons compared with pregnant women not taking antidepressants (depression status unknown) suggested future research should focus on congenital anomalies and autism spectrum and attention deficit disorders in the child. In postpartum depression, low-strength evidence suggested symptom response was not improved when sertraline was added to psychotherapy or when cognitive-behavioral therapy was added to paroxetine. Evidence was insufficient for other outcomes, including depression symptoms, functional capacity, breastfeeding, and infant and child development. A serious limitation is the lack of study populations of exclusively depressed pregnant and postpartum women. CONCLUSION: Evidence about the comparative benefits and harms of pharmacologic treatment of depression in pregnant and postpartum women was largely inadequate to allow informed decisions about treatment. Considering the prevalence of depression, filling this gap is essential.},
number = {3},
urldate = {2022-01-13},
journal = {Obstetrics and gynecology},
author = {McDonagh, Marian S. and Matthews, Annette and Phillipi, Carrie and Romm, Jillian and Peterson, Kim and Thakurta, Sujata and Guise, Jeanne Marie},
year = {2014},
pmid = {25004304},
note = {Publisher: Obstet Gynecol},
keywords = {Annette Matthews, Antidepressive Agents / administration \& dosage, Antidepressive Agents / adverse effects*, Antidepressive Agents / classification, Breast Feeding / adverse effects, Comparative Effectiveness Research, Depression, Depressive Disorder / drug therapy*, Female, Humans, Jeanne-Marie Guise, MEDLINE, Marian S McDonagh, NCBI, NIH, NLM, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, Observational Studies as Topic, P.H.S., Postpartum / drug therapy*, Pregnancy, Pregnancy Complications / drug therapy*, Pregnancy Outcome, PubMed Abstract, Randomized Controlled Trials as Topic, Research Support, Review, Systematic Review, Treatment Outcome, U.S. Gov't, doi:10.1097/AOG.0000000000000410, pmid:25004304},
pages = {526--534},
}
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METHODS OF STUDY SELECTION: Two reviewers independently selected studies of pregnant women with depression comparing antidepressants with each other, placebo or no treatment, or nondrug treatments. Studies making comparisons among women taking antidepressants for any reason and those not taking antidepressants (depression status unknown) were used to fill gaps in the evidence. TABULATION, INTEGRATION, AND RESULTS: Dual study data extraction and quality assessment were used. Six randomized controlled trials and 15 observational studies provided evidence. Low-strength evidence suggested neonates of pregnant women with depression taking selective serotonin reuptake inhibitors had higher risk of respiratory distress than did neonates of untreated women (13.9% compared with 7.8%; P\\textless001) but no difference in risk of neonatal convulsions (0.14% compared with 0.11%; P=.64) or preterm birth (17% compared with 10%; P=.07). Indirect evidence from studies of pregnant women receiving antidepressants for mixed or unreported reasons compared with pregnant women not taking antidepressants (depression status unknown) suggested future research should focus on congenital anomalies and autism spectrum and attention deficit disorders in the child. In postpartum depression, low-strength evidence suggested symptom response was not improved when sertraline was added to psychotherapy or when cognitive-behavioral therapy was added to paroxetine. Evidence was insufficient for other outcomes, including depression symptoms, functional capacity, breastfeeding, and infant and child development. A serious limitation is the lack of study populations of exclusively depressed pregnant and postpartum women. CONCLUSION: Evidence about the comparative benefits and harms of pharmacologic treatment of depression in pregnant and postpartum women was largely inadequate to allow informed decisions about treatment. Considering the prevalence of depression, filling this gap is essential.","number":"3","urldate":"2022-01-13","journal":"Obstetrics and gynecology","author":[{"propositions":[],"lastnames":["McDonagh"],"firstnames":["Marian","S."],"suffixes":[]},{"propositions":[],"lastnames":["Matthews"],"firstnames":["Annette"],"suffixes":[]},{"propositions":[],"lastnames":["Phillipi"],"firstnames":["Carrie"],"suffixes":[]},{"propositions":[],"lastnames":["Romm"],"firstnames":["Jillian"],"suffixes":[]},{"propositions":[],"lastnames":["Peterson"],"firstnames":["Kim"],"suffixes":[]},{"propositions":[],"lastnames":["Thakurta"],"firstnames":["Sujata"],"suffixes":[]},{"propositions":[],"lastnames":["Guise"],"firstnames":["Jeanne","Marie"],"suffixes":[]}],"year":"2014","pmid":"25004304","note":"Publisher: Obstet Gynecol","keywords":"Annette Matthews, Antidepressive Agents / administration & dosage, Antidepressive Agents / adverse effects*, Antidepressive Agents / classification, Breast Feeding / adverse effects, Comparative Effectiveness Research, Depression, Depressive Disorder / drug therapy*, Female, Humans, Jeanne-Marie Guise, MEDLINE, Marian S McDonagh, NCBI, NIH, NLM, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, Observational Studies as Topic, P.H.S., Postpartum / drug therapy*, Pregnancy, Pregnancy Complications / drug therapy*, Pregnancy Outcome, PubMed Abstract, Randomized Controlled Trials as Topic, Research Support, Review, Systematic Review, Treatment Outcome, U.S. Gov't, doi:10.1097/AOG.0000000000000410, pmid:25004304","pages":"526–534","bibtex":"@article{mcdonagh_depression_2014,\n\ttitle = {Depression drug treatment outcomes in pregnancy and the postpartum period: a systematic review and meta-analysis},\n\tvolume = {124},\n\tissn = {1873-233X},\n\turl = {https://pubmed.ncbi.nlm.nih.gov/25004304/},\n\tdoi = {10.1097/AOG.0000000000000410},\n\tabstract = {OBJECTIVE: To evaluate the comparative benefits and harms in both mother and child of antidepressant treatment for depression in pregnant or postpartum women. DATA SOURCES: MEDLINE, the Cochrane Library, CINAHL, Scopus, ClinicalTrials.gov (inception to July 2013), manufacturers, and reference lists. METHODS OF STUDY SELECTION: Two reviewers independently selected studies of pregnant women with depression comparing antidepressants with each other, placebo or no treatment, or nondrug treatments. Studies making comparisons among women taking antidepressants for any reason and those not taking antidepressants (depression status unknown) were used to fill gaps in the evidence. TABULATION, INTEGRATION, AND RESULTS: Dual study data extraction and quality assessment were used. Six randomized controlled trials and 15 observational studies provided evidence. Low-strength evidence suggested neonates of pregnant women with depression taking selective serotonin reuptake inhibitors had higher risk of respiratory distress than did neonates of untreated women (13.9\\% compared with 7.8\\%; P{\\textless}001) but no difference in risk of neonatal convulsions (0.14\\% compared with 0.11\\%; P=.64) or preterm birth (17\\% compared with 10\\%; P=.07). Indirect evidence from studies of pregnant women receiving antidepressants for mixed or unreported reasons compared with pregnant women not taking antidepressants (depression status unknown) suggested future research should focus on congenital anomalies and autism spectrum and attention deficit disorders in the child. In postpartum depression, low-strength evidence suggested symptom response was not improved when sertraline was added to psychotherapy or when cognitive-behavioral therapy was added to paroxetine. Evidence was insufficient for other outcomes, including depression symptoms, functional capacity, breastfeeding, and infant and child development. A serious limitation is the lack of study populations of exclusively depressed pregnant and postpartum women. CONCLUSION: Evidence about the comparative benefits and harms of pharmacologic treatment of depression in pregnant and postpartum women was largely inadequate to allow informed decisions about treatment. 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