Maternal depression, antidepressant prescriptions, and congenital anomaly risk in offspring: a population-based cohort study
Ban, Lu; Gibson, Jack E.; West, Joe; Fiaschi, Linda; Sokal, Rachel; Smeeth, Liam; Doyle, P.; Hubbard, Richard B.; Tata, Laila J.
Jack E. Gibson
JOE WEST JOE.WEST@NOTTINGHAM.AC.UK
Professor of Epidemiology
LINDA FIASCHI LINDA.FIASCHI@NOTTINGHAM.AC.UK
Senior Research Fellow in E-Health
RICHARD HUBBARD email@example.com
Blf/Gsk Professor of Epidemiological Resp Research
Dr LAILA TATA firstname.lastname@example.org
Professor of Epidemiology
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.
Ban, L., Gibson, J. E., West, J., Fiaschi, L., Sokal, R., Smeeth, L., …Tata, L. J. (in press). Maternal depression, antidepressant prescriptions, and congenital anomaly risk in offspring: a population-based cohort study. BJOG: An International Journal of Obstetrics and Gynaecology, 121(12), https://doi.org/10.1111/1471-0528.12682
|Journal Article Type||Article|
|Acceptance Date||Dec 22, 2013|
|Online Publication Date||Mar 11, 2014|
|Deposit Date||Dec 15, 2016|
|Publicly Available Date||Dec 15, 2016|
|Journal||BJOG: An International Journal of Obstetrics and Gynaecology|
|Peer Reviewed||Peer Reviewed|
|Keywords||Antidepressants; Congenital anomaly; Depression; SSRIs; TCAs|
Ban 2014 BJOG.pdf
Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by/4.0