دورية أكاديمية
Maternal depression, antidepressant prescriptions, and congenital anomaly risk in offspring: a population-based cohort study.
العنوان: | Maternal depression, antidepressant prescriptions, and congenital anomaly risk in offspring: a population-based cohort study. |
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المؤلفون: | Ban, L, Gibson, JE, West, J, Fiaschi, L, Sokal, R, Smeeth, L, Doyle, P, Hubbard, RB, Tata, LJ |
المصدر: | BJOG: An International Journal of Obstetrics & Gynaecology; Nov2014, Vol. 121 Issue 12, p1471-1481, 11p |
مصطلحات موضوعية: | ANTIDEPRESSANTS, MENTAL depression, PREGNANCY, SEROTONIN, SEROTONIN syndrome |
مستخلص: | Objective To estimate risks of major congenital anomaly ( MCA) among children of mothers prescribed antidepressants during early pregnancy or diagnosed with depression but without antidepressant prescriptions. Design Population-based cohort study. Setting Linked UK maternal-child primary care records. Population A total of 349 127 singletons liveborn between 1990 and 2009. Methods Odds ratios adjusted for maternal sociodemographics and comorbidities ( aORs) were calculated for MCAs, comparing women with first-trimester selective serotonin reuptake inhibitors (SSRIs) or tricyclic antidepressants (TCAs) and women with diagnosed but unmedicated depression, or women without diagnosed depression. Main outcome measures Fourteen system-specific MCA groups classified according to the European Surveillance of Congenital Anomalies and five specific heart anomaly groups. Results Absolute risks of MCA were 2.7% (95% confidence interval, 95% CI, 2.6-2.8%) in children of mothers without diagnosed depression, 2.8% (95% CI 2.5-3.2%) in children of mothers with unmedicated depression, and 2.7% (95% CI 2.2-3.2%) and 3.1% (95% CI 2.2-4.1%) in children of mothers with SSRIs or TCAs, respectively. Compared with women without depression, MCA overall was not associated with unmedicated depression ( aOR 1.07, 95% CI 0.96-1.18), SSRIs ( aOR 1.01, 95% CI 0.88-1.17), or TCAs ( aOR 1.09, 95% CI 0.87-1.38). Paroxetine was associated with increased heart anomalies (absolute risk 1.4% in the exposed group compared with 0.8% in women without depression; aOR 1.78, 95% CI 1.09-2.88), which decreased marginally when compared with women with diagnosed but unmedicated depression ( aOR 1.67, 95% CI 1.00-2.80). Conclusions Overall MCA risk did not increase with maternal depression or with antidepressant prescriptions. Paroxetine was associated with increases of heart anomalies, although this could represent a chance finding from a large number of comparisons undertaken. [ABSTRACT FROM AUTHOR] |
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قاعدة البيانات: | Complementary Index |
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