scholarly journals Antidepressant use during pregnancy and the risk of major congenital malformations in a cohort of depressed pregnant women: an updated analysis of the Quebec Pregnancy Cohort

BMJ Open ◽  
2017 ◽  
Vol 7 (1) ◽  
pp. e013372 ◽  
Author(s):  
Anick Bérard ◽  
Jin-Ping Zhao ◽  
Odile Sheehy
Keyword(s):  
Pregnant Women ◽  
Congenital Malformations ◽  
Pregnancy Cohort ◽  
Antidepressant Use ◽  
Major Congenital Malformations

Antidepressant use During Pregnancy and the Risk of Major Congenital Malformations in a Cohort of Depressed Pregnant Women: A Re-analysis of the Quebec Pregnancy Cohort

2017 ◽  
Vol 41 (S1) ◽  
pp. S155-S155
Author(s):  
A. Bérard ◽  
J.P. Zhao ◽  
O. Sheehy
Keyword(s):  
Pregnant Women ◽  
Serotonin Reuptake ◽  
Congenital Malformations ◽  
Selective Serotonin Reuptake Inhibitors ◽  
First Trimester ◽  
Pregnancy Cohort ◽  
Organ Specific ◽  
Antidepressant Use ◽  
Major Congenital Malformations ◽  
First Year Of Life

ObjectiveTo quantify the association between first-trimester antidepressant exposure and the risk of major congenital malformations (MCM) in a cohort of depressed women.MethodData were obtained from the Quebec pregnancy cohort. All pregnancies with a diagnosis of depression or anxiety, or exposed to antidepressants in the 12 months before pregnancy, and ending with a live-born singleton were included. Antidepressant classes (selective serotonin reuptake inhibitors (SSRI), serotonin norepinephrine reuptake inhibitors (SNRI), tricyclic antidepressants (TCA), and other antidepressants), and types were individually compared to non-exposure during the first-trimester (depressed untreated). MCM overall and organ-specific malformations in the first year of life were identified.ResultEighteen thousand four hundred and eighty-seven depressed pregnant women were included. Citalopram use during the first-trimester was increasing the risk of MCM (aOR 1.36, 95%CI 1.08, 1.73; 88 exposed cases). Antidepressants with serotonin reuptake inhibition effect (SSRI, SNRI, amitriptyline (the most used TCA)) were increasing the risk of certain organ specific defects: paroxetine was increasing the risk of cardiac defects (aOR 1.45, 95%CI 1.12, 1.88), and ventricular/atrial septal defects (aOR 1.39, 95%CI 1.00. 1.93); citalopram was increasing the risk of musculoskeletal defects (aOR 1.92, 95%CI 1.40. 2.62), and cranyosynostosis (aOR 3.95, 95%CI 2.08, 7.52); TCA was associated with eye, ear, face and neck defects (aOR 2.45, 95%CI 1.05, 5.72), and digestive defects (aOR 2.55, 95%CI 1.40. 4.66); and venlafaxine was associated with respiratory defects (aOR 2.17, 95%CI 1.07, 4.38).ConclusionAntidepressants with effects on serotonin reuptake during embryogenesis are increasing the risk of some organ specific malformations in a cohort of pregnant women with depression.Disclosure of interestCOI: Disclosures and acknowledgments: AB is a consultant for plaintiffs in litigations involving antidepressants and birth defects. All other authors report no financial relationships with commercial interests. All authors have completed the ICMJE uniform disclosure form.

scholarly journals Duration of antidepressant use during pregnancy and risk of major congenital malformations

2008 ◽  
Vol 192 (5) ◽  
pp. 344-350 ◽  
Author(s):  
Élodie Ramos ◽  
Martin St-André ◽  
Évelyne Rey ◽  
Driss Oraichi ◽  
Anick Bérard
Keyword(s):  
Psychiatric Disorders ◽  
Congenital Malformation ◽  
Congenital Malformations ◽  
First Trimester ◽  
Major Congenital Malformation ◽  
Increased Risk ◽  
First Trimester Of Pregnancy ◽  
Antidepressant Use ◽  
Major Congenital Malformations ◽  
First Year Of Life

BackgroundAntidepressant use during the gestational period is a controversial topic.AimsTo determine whether duration of antidepressant use during the first trimester increases the risk of major congenital malformations in offspring of women diagnosed with psychiatric disorders.MethodA case-control study was performed among women who had been pregnant between January 1998 and December 2002. Data were obtained from a Medication and Pregnancy registry, built by linking three databases from the province of Quebec, and a self-administered questionnaire. Women eligible for this study had to be 15–45 years old at the beginning of pregnancy, have at least one diagnosis of psychiatric disorder before pregnancy, have used antidepressants for ≥ 30 days in the year prior to pregnancy and have a pregnancy ending with a delivery. Cases were defined as any major congenital malformation diagnosed in the offspring's first year of life. Odds ratios, adjusted for relevant confounders, were estimated using logistic regression.ResultsAmong the 2329 women meeting the inclusion criteria, 189 (8.1%) infants were born with a major congenital malformation. Duration of antidepressant use during the first trimester of pregnancy was not associated with an increased risk of major congenital malformations: 1–30 days v. 0 day, adjusted OR=1.23 (95% CI 0.77–1.98); 31–60 days v. 0 day, adjusted OR=1.03 (95% CI 0.63–1.69); ≥ 61 days v. 0 day, adjusted OR=0.92 (95% CI 0.50–1.69).ConclusionsThese data do not support an association between duration of antidepressant use during the first trimester of pregnancy and major congenital malformations in the offspring of women with psychiatric disorders. These findings should help clinicians decide whether to continue antidepressant therapy during pregnancy.

172-LB: Risk of Major Congenital Malformations, Perinatal or Neonatal Death with Insulin Detemir Compared with Other Basal Insulins in Pregnant Women with Preexisting Diabetes: The EVOLVE Study

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 172-LB
Author(s):  
ELISABETH R. MATHIESEN ◽  
AMRA CIRIC ALIBEGOVIC ◽  
LISE LOTTE N. HUSEMOEN ◽  
PRANAV KELKAR ◽  
DAVID R. MCCANCE ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Congenital Malformations ◽  
Neonatal Death ◽  
Insulin Detemir ◽  
Major Congenital Malformations

scholarly journals Development of EpiRisk: An online clinical tool for estimating the risk of major congenital malformations in pregnant women treated for epilepsy

2018 ◽  
Vol 3 (2) ◽  
pp. 281-285
Author(s):  
Gabriel Davis Jones ◽  
Alison Hitchcock ◽  
Frank Vajda ◽  
John Craig ◽  
Terence J. O'Brien ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Congenital Malformations ◽  
Clinical Tool ◽  
Major Congenital Malformations

scholarly journals The hidden burden of adolescent pregnancies in rural Sri Lanka; findings of the Rajarata Pregnancy Cohort

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Thilini Chanchala Agampodi ◽  
Nuwan Darshana Wickramasinghe ◽  
Hemali Gayathri Jayakodi ◽  
Gayani Shashikala Amarasinghe ◽  
Janith Niwanthaka Warnasekara ◽  
...  
Keyword(s):  
Mental Health ◽  
Sri Lanka ◽  
Pregnant Women ◽  
Adolescent Mothers ◽  
Depression Scale ◽  
Ultra Sound ◽  
Physical And Mental Health ◽  
Pregnancy Cohort ◽  
Contraceptive Usage ◽  
Adolescent Pregnancies

Abstract Background Adolescent fertility is a main indicator of the Sustainable Developmental Goal (SGD) three. Although Sri Lanka is exemplary in maternal health, the utilization of Sexual and Reproductive Health services (SRH) by adolescents is less documented. We describe the hidden burden, associated biological and psychosocial factors and utilization patterns of pre-conceptional services among pregnant adolescents in rural Sri Lanka. Methods The study is based on the baseline assessment of the Rajarata Pregnancy Cohort (RaPCo) in Anuradhapura. Pregnant women newly registered from July to September 2019 were recruited to the study. The period of gestation was confirmed during the second follow-up visit (around 25–28 weeks of gestation) using ultra sound scan data. A history, clinical examination, anthropometric measurements, blood investigations were conducted. Mental health status was assessed using the Edinburgh Postpartum Depression Scale (EPDS). Results Baseline data on gestation was completed by 3,367 pregnant women. Of them, 254 (7.5%) were adolescent pregnancies. Among the primigravida mothers (n = 1037), 22.4% (n = 233) were adolescent pregnancies. Maternal and paternal low education level, being unmarried, and less time since marriage were statistically significant factors associated with adolescent pregnancies (p < 0.05). Contraceptive usage before pregnancy, utilization of pre-conceptional health care services, planning pregnancy and consuming folic acid was significantly low among adolescents (p < 0.001). They also had low body mass index (p < 0.001) and low hemoglobin levels (p = 0.03). Adolescent mothers were less happy of being pregnant (p = 0.006) and had significantly higher levels of anxiety (p = 0.009). Conclusion One fifth of women in their first pregnancy in this study population are adolescents. Nulli-parous adolescents exert poor social stability and compromised physical and mental health effects. The underutilization and/or unavailability of SRH services is clearly associated with adolescent pregnancies.

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