The international prevalence of antidepressant use before, during, and after pregnancy: A systematic review and meta-analysis of timing, type of prescriptions and geographical variability. Molenaar, N., M., Bais, B., Lambregtse-van den Berg, M., P., Mulder, C., L., Howell, E., A., Fox, N., S., Rommel, A., Bergink, V., & Kamperman, A., M. 3, 2020. Paper Website doi abstract bibtex 1 download Background: Antidepressant use during pregnancy has increased over the last decades, while safety has been under debate. Our aim was to measure the international prevalence of antidepressant use before, during, and after pregnancy and examine timing, type of prescriptions and geographic variability. Methods: We searched Embase, Medline Ovid, Web of Science, Cochrane Central and Google Scholar from their inception until February 19, 2019. We determined pooled prevalence estimates of antidepressants before, during, and after pregnancy, as well as stratified according to substantive variables. Results: We identified 40 cohorts from 15 countries, together reporting on 14,072,251 pregnancies. Included studies had a low risk of bias, often reporting on large representative cohorts. Selective serotonin reuptake inhibitors (SSRIs) were the most commonly used antidepressants during pregnancy, with an international prevalence estimate of 3.0% (95%CI 2.3;3.7). While Europe and Australasia had pooled prevalence estimates of 1.6% and 1.3% respectively, Northern America had a prevalence estimate of 5.5% (Q-value = 126.19; df = 2; p-value<0.01). Highest SSRI prevalence rates were found for sertraline (1.10%), followed by citalopram and fluoxetine (0.77% and 0.76% respectively) (Q-value = 121.25; df = 5; p-value<0.01). Qualitative analysis indicated an increase in antidepressant use over subsequent calendar years. Limitations: Substantial heterogeneity remained unaccounted for throughout the analyses, even after accounting for hypothetical contributors. Conclusions: This meta-analysis revealed substantial regional differences in antidepressant use around pregnancy, which could be due to variability in prescription behavior, healthcare seeking behavior and organization of healthcare. There is an urgent need for evidence on effectiveness, benefit, and harm of antidepressants during pregnancy to guide clinical practice.
@misc{
title = {The international prevalence of antidepressant use before, during, and after pregnancy: A systematic review and meta-analysis of timing, type of prescriptions and geographical variability},
type = {misc},
year = {2020},
source = {Journal of Affective Disorders},
keywords = {Antidepressants,Epidemiology,Meta-analysis,Pregnancy,Prevalence,Systematic review},
pages = {82-89},
volume = {264},
websites = {www.elsevier.com/locate/jad,https://pubmed.ncbi.nlm.nih.gov/31846905/},
month = {3},
publisher = {Elsevier B.V.},
day = {1},
id = {20fd03e2-ee8b-3aba-87ca-fbe2b3d42964},
created = {2021-05-07T15:14:15.874Z},
accessed = {2020-09-30},
file_attached = {true},
profile_id = {031c901b-e377-3792-995f-e5d0201f5174},
last_modified = {2021-05-12T18:12:56.646Z},
read = {false},
starred = {false},
authored = {true},
confirmed = {true},
hidden = {false},
folder_uuids = {587bd3ee-2583-429f-bd31-12ed8aa89b37},
private_publication = {false},
abstract = {Background: Antidepressant use during pregnancy has increased over the last decades, while safety has been under debate. Our aim was to measure the international prevalence of antidepressant use before, during, and after pregnancy and examine timing, type of prescriptions and geographic variability. Methods: We searched Embase, Medline Ovid, Web of Science, Cochrane Central and Google Scholar from their inception until February 19, 2019. We determined pooled prevalence estimates of antidepressants before, during, and after pregnancy, as well as stratified according to substantive variables. Results: We identified 40 cohorts from 15 countries, together reporting on 14,072,251 pregnancies. Included studies had a low risk of bias, often reporting on large representative cohorts. Selective serotonin reuptake inhibitors (SSRIs) were the most commonly used antidepressants during pregnancy, with an international prevalence estimate of 3.0% (95%CI 2.3;3.7). While Europe and Australasia had pooled prevalence estimates of 1.6% and 1.3% respectively, Northern America had a prevalence estimate of 5.5% (Q-value = 126.19; df = 2; p-value<0.01). Highest SSRI prevalence rates were found for sertraline (1.10%), followed by citalopram and fluoxetine (0.77% and 0.76% respectively) (Q-value = 121.25; df = 5; p-value<0.01). Qualitative analysis indicated an increase in antidepressant use over subsequent calendar years. Limitations: Substantial heterogeneity remained unaccounted for throughout the analyses, even after accounting for hypothetical contributors. Conclusions: This meta-analysis revealed substantial regional differences in antidepressant use around pregnancy, which could be due to variability in prescription behavior, healthcare seeking behavior and organization of healthcare. There is an urgent need for evidence on effectiveness, benefit, and harm of antidepressants during pregnancy to guide clinical practice.},
bibtype = {misc},
author = {Molenaar, Nina M. and Bais, Babette and Lambregtse-van den Berg, Mijke P. and Mulder, Cornelis L. and Howell, Elizabeth A. and Fox, Nathan S. and Rommel, Anna-Sophie and Bergink, Veerle and Kamperman, Astrid M.},
doi = {10.1016/j.jad.2019.12.014}
}
Downloads: 1
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While Europe and Australasia had pooled prevalence estimates of 1.6% and 1.3% respectively, Northern America had a prevalence estimate of 5.5% (Q-value = 126.19; df = 2; p-value<0.01). Highest SSRI prevalence rates were found for sertraline (1.10%), followed by citalopram and fluoxetine (0.77% and 0.76% respectively) (Q-value = 121.25; df = 5; p-value<0.01). Qualitative analysis indicated an increase in antidepressant use over subsequent calendar years. Limitations: Substantial heterogeneity remained unaccounted for throughout the analyses, even after accounting for hypothetical contributors. Conclusions: This meta-analysis revealed substantial regional differences in antidepressant use around pregnancy, which could be due to variability in prescription behavior, healthcare seeking behavior and organization of healthcare. There is an urgent need for evidence on effectiveness, benefit, and harm of antidepressants during pregnancy to guide clinical practice.","bibtype":"misc","author":"Molenaar, Nina M. and Bais, Babette and Lambregtse-van den Berg, Mijke P. and Mulder, Cornelis L. and Howell, Elizabeth A. and Fox, Nathan S. and Rommel, Anna-Sophie and Bergink, Veerle and Kamperman, Astrid M.","doi":"10.1016/j.jad.2019.12.014","bibtex":"@misc{\n title = {The international prevalence of antidepressant use before, during, and after pregnancy: A systematic review and meta-analysis of timing, type of prescriptions and geographical variability},\n type = {misc},\n year = {2020},\n source = {Journal of Affective Disorders},\n keywords = {Antidepressants,Epidemiology,Meta-analysis,Pregnancy,Prevalence,Systematic review},\n pages = {82-89},\n volume = {264},\n websites = {www.elsevier.com/locate/jad,https://pubmed.ncbi.nlm.nih.gov/31846905/},\n month = {3},\n publisher = {Elsevier B.V.},\n day = {1},\n id = {20fd03e2-ee8b-3aba-87ca-fbe2b3d42964},\n created = {2021-05-07T15:14:15.874Z},\n accessed = {2020-09-30},\n file_attached = {true},\n profile_id = {031c901b-e377-3792-995f-e5d0201f5174},\n last_modified = {2021-05-12T18:12:56.646Z},\n read = {false},\n starred = {false},\n authored = {true},\n confirmed = {true},\n hidden = {false},\n folder_uuids = {587bd3ee-2583-429f-bd31-12ed8aa89b37},\n private_publication = {false},\n abstract = {Background: Antidepressant use during pregnancy has increased over the last decades, while safety has been under debate. 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