Antidepressant use during pregnancy and risk of adverse neonatal outcomes: A comprehensive investigation of previously identified associations. Rommel, A., Momen, N., C., Molenaar, N., M., Agerbo, E., Bergink, V., Munk-Olsen, T., & Liu, X. Acta Psychiatrica Scandinavica, 145(6):544-556, John Wiley & Sons, Ltd, 2022.
Antidepressant use during pregnancy and risk of adverse neonatal outcomes: A comprehensive investigation of previously identified associations [link]Website  doi  abstract   bibtex   6 downloads  
Objective: Prenatal antidepressant use is widespread. Observational studies have investigated the neonatal effects of prenatal antidepressant exposure with inconclusive results. We aimed to comprehensively investigate the associations between prenatal antidepressant exposure and the most commonly studied adverse neonatal outcomes: preterm birth, birthweight, poor neonatal adaptation, persistent pulmonary hypertension of the neonate (PPHN), neonatal admission and congenital malformations. Methods: We included 45,590 singletons (born 1998–2011) whose mothers used antidepressants within two years before pregnancy. Children were categorised into two groups: continuation (antidepressant use before and during pregnancy) or discontinuation (antidepressant use before but not during pregnancy). We applied random-effects logistic and linear regressions, adjusting for covariates. Results: After adjusting for confounders, prenatal antidepressant exposure was associated with a 2.3 day (95% CI −2.9; −2.0) decrease in gestational age and a 51 g (95% CI −62g; −41 g) decrease in birthweight. The continuation group was at increased risk for moderate-to-late preterm birth (32–37 weeks) (aOR = 1.43; 95%CI 1.33; 1.55), moderately low birthweight (1500–2499 g) (aOR = 1.28; 95%CI 1.17; 1.41), postnatal adaptation syndrome (aOR = 2.59; 95%CI 1.87; 3.59) and neonatal admission (aOR = 1.52; 95%CI 1.44; 1.60) compared to the discontinuation group. Conclusion: Prenatal antidepressant exposure was associated with small decreases in gestational age and birthweight, as well as higher risk for moderate-to-late preterm birth, moderately low birthweight, neonatal admission and postnatal adaptation syndrome. No differences in risk were found for PPHN, or congenital malformations. The causality of the observed associations cannot be established due to the potential for unmeasured residual confounding linked to the underlying disease.
@article{
 title = {Antidepressant use during pregnancy and risk of adverse neonatal outcomes: A comprehensive investigation of previously identified associations},
 type = {article},
 year = {2022},
 keywords = {antidepressants,low birthweight,neonatal outcomes,perinatal depression,preterm birth},
 pages = {544-556},
 volume = {145},
 websites = {https://onlinelibrary-wiley-com.eresources.mssm.edu/doi/full/10.1111/acps.13409,https://onlinelibrary-wiley-com.eresources.mssm.edu/doi/abs/10.1111/acps.13409,https://onlinelibrary-wiley-com.eresources.mssm.edu/doi/10.1111/acps.13409},
 publisher = {John Wiley & Sons, Ltd},
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 created = {2022-04-14T13:56:25.055Z},
 accessed = {2022-04-14},
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 last_modified = {2022-05-17T14:14:59.932Z},
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 abstract = {Objective: Prenatal antidepressant use is widespread. Observational studies have investigated the neonatal effects of prenatal antidepressant exposure with inconclusive results. We aimed to comprehensively investigate the associations between prenatal antidepressant exposure and the most commonly studied adverse neonatal outcomes: preterm birth, birthweight, poor neonatal adaptation, persistent pulmonary hypertension of the neonate (PPHN), neonatal admission and congenital malformations. Methods: We included 45,590 singletons (born 1998–2011) whose mothers used antidepressants within two years before pregnancy. Children were categorised into two groups: continuation (antidepressant use before and during pregnancy) or discontinuation (antidepressant use before but not during pregnancy). We applied random-effects logistic and linear regressions, adjusting for covariates. Results: After adjusting for confounders, prenatal antidepressant exposure was associated with a 2.3 day (95% CI −2.9; −2.0) decrease in gestational age and a 51 g (95% CI −62g; −41 g) decrease in birthweight. The continuation group was at increased risk for moderate-to-late preterm birth (32–37 weeks) (aOR = 1.43; 95%CI 1.33; 1.55), moderately low birthweight (1500–2499 g) (aOR = 1.28; 95%CI 1.17; 1.41), postnatal adaptation syndrome (aOR = 2.59; 95%CI 1.87; 3.59) and neonatal admission (aOR = 1.52; 95%CI 1.44; 1.60) compared to the discontinuation group. Conclusion: Prenatal antidepressant exposure was associated with small decreases in gestational age and birthweight, as well as higher risk for moderate-to-late preterm birth, moderately low birthweight, neonatal admission and postnatal adaptation syndrome. No differences in risk were found for PPHN, or congenital malformations. The causality of the observed associations cannot be established due to the potential for unmeasured residual confounding linked to the underlying disease.},
 bibtype = {article},
 author = {Rommel, Anna-Sophie and Momen, Natalie C. and Molenaar, Nina Maren and Agerbo, Esben and Bergink, Veerle and Munk-Olsen, Trine and Liu, Xiaoqin},
 doi = {10.1111/ACPS.13409},
 journal = {Acta Psychiatrica Scandinavica},
 number = {6}
}

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