Yeon Mi Hwang, Ryan T Roper, Samantha N Piekos, Daniel A Enquobahrie, Mary F Hebert, Alison G Paquette, Priyanka Baloni, Nathan D Price, Leroy Hood, Jennifer J Hadlock
{"title":"选择性 5-羟色胺再摄取抑制剂的使用时机与早产及相关不良事件的风险：对 COVID-19 大流行时期的考虑。","authors":"Yeon Mi Hwang, Ryan T Roper, Samantha N Piekos, Daniel A Enquobahrie, Mary F Hebert, Alison G Paquette, Priyanka Baloni, Nathan D Price, Leroy Hood, Jennifer J Hadlock","doi":"10.1080/14767058.2024.2313364","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>There is uncertainty around the safety of SSRIs for treating depression during pregnancy. Nevertheless, the use of SSRIs has been gradually increasing, especially during the COVID-19 pandemic period. We aimed to (1) characterize maternal depression rate and use of SSRIs in a recent 10-year period, (2) address confounding by indication, as well as socioeconomic and environmental factors, and (3) evaluate associations of the timing of SSRI exposure in pregnancy with risk for preterm birth (PTB), low birthweight (LBW), and small for gestational age (SGA) infants among women with depression before pregnancy.</p><p><strong>Methods: </strong>We conducted propensity score-adjusted regression to calculate odds ratios (ORs) of PTB, LBW, and SGA. We accounted for maternal/pregnancy characteristics, comorbidity, depression severity, time of delivery, social vulnerability, and rural residence.</p><p><strong>Results: </strong>There were 50.3% and 40.3% increases in the prevalence rate of prenatal depression and prenatal SSRI prescription rate during the pandemic. We identified women with depression ≤180 days before pregnancy (<i>n</i> = 8406). Women with no SSRI order during pregnancy (<i>n</i> = 3760) constituted the unexposed group. The late SSRI exposure group consisted of women with an SSRI order after the first trimester (<i>n</i> = 3759). The early-only SSRI exposure group consisted of women with SSRI orders only in the first trimester (<i>n</i> = 887). The late SSRI exposure group had an increased risk of PTB of OR = 1.5 ([1.2,1.8]) and LBW of OR = 1.5 ([1.2,2.0]), relative to the unexposed group. Associations between late SSRI exposure and risk of PTB/LBW were similar among a subsample of patients who delivered during the pandemic.</p><p><strong>Conclusions: </strong>These findings suggest an association between PTB/LBW and SSRI exposure is dependent on exposure timing during pregnancy. Small for gestational age is not associated with SSRI exposure.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"37 1","pages":"2313364"},"PeriodicalIF":1.7000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11033706/pdf/","citationCount":"0","resultStr":"{\"title\":\"Timing of selective serotonin reuptake inhibitor use and risk for preterm birth and related adverse events: with a consideration of the COVID-19 pandemic period.\",\"authors\":\"Yeon Mi Hwang, Ryan T Roper, Samantha N Piekos, Daniel A Enquobahrie, Mary F Hebert, Alison G Paquette, Priyanka Baloni, Nathan D Price, Leroy Hood, Jennifer J Hadlock\",\"doi\":\"10.1080/14767058.2024.2313364\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>There is uncertainty around the safety of SSRIs for treating depression during pregnancy. Nevertheless, the use of SSRIs has been gradually increasing, especially during the COVID-19 pandemic period. We aimed to (1) characterize maternal depression rate and use of SSRIs in a recent 10-year period, (2) address confounding by indication, as well as socioeconomic and environmental factors, and (3) evaluate associations of the timing of SSRI exposure in pregnancy with risk for preterm birth (PTB), low birthweight (LBW), and small for gestational age (SGA) infants among women with depression before pregnancy.</p><p><strong>Methods: </strong>We conducted propensity score-adjusted regression to calculate odds ratios (ORs) of PTB, LBW, and SGA. We accounted for maternal/pregnancy characteristics, comorbidity, depression severity, time of delivery, social vulnerability, and rural residence.</p><p><strong>Results: </strong>There were 50.3% and 40.3% increases in the prevalence rate of prenatal depression and prenatal SSRI prescription rate during the pandemic. We identified women with depression ≤180 days before pregnancy (<i>n</i> = 8406). Women with no SSRI order during pregnancy (<i>n</i> = 3760) constituted the unexposed group. The late SSRI exposure group consisted of women with an SSRI order after the first trimester (<i>n</i> = 3759). The early-only SSRI exposure group consisted of women with SSRI orders only in the first trimester (<i>n</i> = 887). The late SSRI exposure group had an increased risk of PTB of OR = 1.5 ([1.2,1.8]) and LBW of OR = 1.5 ([1.2,2.0]), relative to the unexposed group. Associations between late SSRI exposure and risk of PTB/LBW were similar among a subsample of patients who delivered during the pandemic.</p><p><strong>Conclusions: </strong>These findings suggest an association between PTB/LBW and SSRI exposure is dependent on exposure timing during pregnancy. 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Timing of selective serotonin reuptake inhibitor use and risk for preterm birth and related adverse events: with a consideration of the COVID-19 pandemic period.
Objective: There is uncertainty around the safety of SSRIs for treating depression during pregnancy. Nevertheless, the use of SSRIs has been gradually increasing, especially during the COVID-19 pandemic period. We aimed to (1) characterize maternal depression rate and use of SSRIs in a recent 10-year period, (2) address confounding by indication, as well as socioeconomic and environmental factors, and (3) evaluate associations of the timing of SSRI exposure in pregnancy with risk for preterm birth (PTB), low birthweight (LBW), and small for gestational age (SGA) infants among women with depression before pregnancy.
Methods: We conducted propensity score-adjusted regression to calculate odds ratios (ORs) of PTB, LBW, and SGA. We accounted for maternal/pregnancy characteristics, comorbidity, depression severity, time of delivery, social vulnerability, and rural residence.
Results: There were 50.3% and 40.3% increases in the prevalence rate of prenatal depression and prenatal SSRI prescription rate during the pandemic. We identified women with depression ≤180 days before pregnancy (n = 8406). Women with no SSRI order during pregnancy (n = 3760) constituted the unexposed group. The late SSRI exposure group consisted of women with an SSRI order after the first trimester (n = 3759). The early-only SSRI exposure group consisted of women with SSRI orders only in the first trimester (n = 887). The late SSRI exposure group had an increased risk of PTB of OR = 1.5 ([1.2,1.8]) and LBW of OR = 1.5 ([1.2,2.0]), relative to the unexposed group. Associations between late SSRI exposure and risk of PTB/LBW were similar among a subsample of patients who delivered during the pandemic.
Conclusions: These findings suggest an association between PTB/LBW and SSRI exposure is dependent on exposure timing during pregnancy. Small for gestational age is not associated with SSRI exposure.
期刊介绍：
The official journal of The European Association of Perinatal Medicine, The Federation of Asia and Oceania Perinatal Societies and The International Society of Perinatal Obstetricians. The journal publishes a wide range of peer-reviewed research on the obstetric, medical, genetic, mental health and surgical complications of pregnancy and their effects on the mother, fetus and neonate. Research on audit, evaluation and clinical care in maternal-fetal and perinatal medicine is also featured.
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