Advising on Antidepressant Use in Pregnancy: Are We All on the Same Page?

IF 3.8 3区医学 Q2 PSYCHIATRY

Asia‐Pacific Psychiatry Pub Date : 2026-06-25 DOI:10.1111/appy.70029

Lucy Charlotte Broughton, Natalie Hughes, Jiaxu Zeng, Alesha Smith

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Abstract

Purpose

Perinatal mood disorders are associated with adverse maternal and neonatal outcomes and affect 15%–20% of pregnant people. Guidelines recommend SSRIs when non-pharmacological therapies are ineffective, yet antenatal depression remains undertreated. This study aimed to assess the attitudes, knowledge, and practices of general practitioners (GPs) and midwives on SSRI use in pregnancy.

Methods

A knowledge, attitudes, and practice survey was developed in QualtricsXM and distributed to New Zealand-registered GPs and midwives between May 2023 and October 2024 using convenience sampling.

Results

Responses from 119 GPs and 62 midwives were analyzed. Discomfort managing antenatal depression was reported by 11% of GPs and 36% of midwives. Knowledge of SSRI risks in pregnancy varied among respondents. Average concern regarding the use of SSRIs in pregnancy and the risk of adverse outcomes was low, but there was considerable variation. In the case vignette, recommended actions differed: 53% advised maintaining treatment, 13% suggested dose reduction, and 24% recommended switching antidepressants. Patient counseling was limited, and appropriate written patient information was rarely provided.

Conclusions

This study highlights variability in knowledge, attitudes, and practices among GP's and midwives regarding SSRIs during pregnancy. Further training, improved access to patient information, and decision aids could enhance patient-centered care and ensure pregnant people receive balanced, evidence-based guidance on SSRI use.

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怀孕期间服用抗抑郁药的建议：我们都在同一条战线上吗？

目的围产期情绪障碍与孕产妇和新生儿不良结局相关，影响15%-20%的孕妇。当非药物治疗无效，但产前抑郁症仍未得到充分治疗时，指南推荐使用ssri类药物。本研究旨在评估全科医生（gp）和助产士在妊娠期使用SSRI的态度、知识和实践。方法于2023年5月至2024年10月在QualtricsXM中开展知识、态度和实践调查，并采用方便抽样的方式向新西兰注册的全科医生和助产士发放调查问卷。结果分析119名全科医生和62名助产士的反馈。11%的全科医生和36%的助产士报告了产前抑郁症的不适。调查对象对妊娠期SSRI风险的了解程度各不相同。对妊娠期使用ssri类药物和不良后果风险的平均关注度较低，但存在相当大的差异。在病例简介中，推荐的措施不同：53%建议维持治疗，13%建议减少剂量，24%建议转换抗抑郁药。患者咨询是有限的，并且很少提供适当的书面患者信息。结论：本研究强调了全科医生和助产士在怀孕期间关于SSRIs的知识、态度和实践方面的差异。进一步的培训、改善对患者信息的获取和决策辅助可以加强以患者为中心的护理，并确保孕妇在SSRI使用方面得到平衡的、基于证据的指导。

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来源期刊

Asia‐Pacific Psychiatry PSYCHIATRY-

CiteScore

7.80

自引率

0.00%

发文量

审稿时长

>12 weeks

期刊介绍： Asia-Pacific Psychiatry is an international psychiatric journal focused on the Asia and Pacific Rim region, and is the official journal of the Pacific Rim College of Psychiatrics. Asia-Pacific Psychiatry enables psychiatric and other mental health professionals in the region to share their research, education programs and clinical experience with a larger international readership. The journal offers a venue for high quality research for and from the region in the face of minimal international publication availability for authors concerned with the region. This includes findings highlighting the diversity in psychiatric behaviour, treatment and outcome related to social, ethnic, cultural and economic differences of the region. The journal publishes peer-reviewed articles and reviews, as well as clinically and educationally focused papers on regional best practices. Images, videos, a young psychiatrist''s corner, meeting reports, a journal club and contextual commentaries differentiate this journal from existing main stream psychiatry journals that are focused on other regions, or nationally focused within countries of Asia and the Pacific Rim.