Lu Ban email@example.com
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 GIBSON firstname.lastname@example.org
Assistant Professor in Epidemiology
JOE WEST JOE.WEST@NOTTINGHAM.AC.UK
Professor of Epidemiology
LINDA FIASCHI LINDA.FIASCHI@NOTTINGHAM.AC.UK
Senior Research Fellow in Ehealth
RICHARD HUBBARD email@example.com
Blf/Gsk Professor of Epidemiological Resp Research
Dr LAILA TATA firstname.lastname@example.org
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.
|Journal Article Type||Article|
|Journal||BJOG: An International Journal of Obstetrics and Gynaecology|
|Peer Reviewed||Peer Reviewed|
|APA6 Citation||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|
|Keywords||Antidepressants; Congenital anomaly; Depression; SSRIs; TCAs|
|Copyright Statement||Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by/4.0|
Ban 2014 BJOG.pdf
Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by/4.0
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