The impact of exposure to antidepressant medications during pregnancy on neonatal outcomes

a review of retrospective database cohort studies

Casey R. Tak, Kathleen M. Job, Katie Schoen-Gentry, Sarah C. Campbell, Patrick Carroll, Maged Costantine, Diana Brixner, Angela K. Birnbaum, Catherine M.T. Sherwin

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Introduction: Concerns with prescription antidepressant use in pregnant women have instigated the examination of potential associations between fetal exposure to antidepressant medication and outcomes including preterm delivery, congenital malformations, perinatal and post-natal adverse events, persistent pulmonary hypertension, and mortality. The retrospective cohort model is an often utilized study design. The objective of this review is to evaluate the literature on antidepressant use in pregnancy conducted as retrospective cohorts in national/regional medical, or claims databases that assess neonatal and infant outcomes for agreement between studies, ultimately providing a methodological and outcomes summary for future scientific endeavors. Methods: PubMed was searched for literature relating to antidepressant use and infant outcomes from the earliest available date through July 15, 2016. Studies with a retrospective cohort design and conducted in national/regional medical or claims databases were included. Searched outcomes included preterm delivery, congenital malformations, low birth weight, small for gestational age, persistent pulmonary hypertension of the newborn, and other select adverse events comprising low Apgar score (5 min), convulsions/seizures, respiratory distress/problems, fetal mortality, and infant mortality. Results: Of the 784 studies identified, 36 retrospective cohort studies met eligibility criteria. An increase in preterm delivery and respiratory distress/problems and no increase in congenital malformation or fetal and infant death were associated with prenatal use of prescription antidepressants by majority consensus (at least 2/3 [67%] of studies). Conclusions: While consensus indicates that perinatal prescription antidepressant use has consequences for the fetus and infant, there are notable inconsistencies in the literature. More investigations that address prenatal exposure to depression and other important covariates are needed.

Original languageEnglish (US)
Pages (from-to)1-15
Number of pages15
JournalEuropean Journal of Clinical Pharmacology
DOIs
StateAccepted/In press - Jun 9 2017

Fingerprint

Antidepressive Agents
Cohort Studies
Databases
Pregnancy
Prescriptions
Seizures
Persistent Fetal Circulation Syndrome
Fetal Mortality
Fetal Death
Apgar Score
Infant Mortality
Low Birth Weight Infant
Pulmonary Hypertension
PubMed
Gestational Age
Pregnant Women
Fetus
Retrospective Studies
Mortality

Keywords

  • Antidepressants
  • Database
  • Maternal-fetal pharmacology
  • Neonatal outcomes
  • Pregnancy
  • Retrospective cohort study

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)

Cite this

The impact of exposure to antidepressant medications during pregnancy on neonatal outcomes : a review of retrospective database cohort studies. / Tak, Casey R.; Job, Kathleen M.; Schoen-Gentry, Katie; Campbell, Sarah C.; Carroll, Patrick; Costantine, Maged; Brixner, Diana; Birnbaum, Angela K.; Sherwin, Catherine M.T.

In: European Journal of Clinical Pharmacology, 09.06.2017, p. 1-15.

Research output: Contribution to journalArticle

Tak, Casey R. ; Job, Kathleen M. ; Schoen-Gentry, Katie ; Campbell, Sarah C. ; Carroll, Patrick ; Costantine, Maged ; Brixner, Diana ; Birnbaum, Angela K. ; Sherwin, Catherine M.T. / The impact of exposure to antidepressant medications during pregnancy on neonatal outcomes : a review of retrospective database cohort studies. In: European Journal of Clinical Pharmacology. 2017 ; pp. 1-15.
@article{916794bfa93041d9a9245e695f11b405,
title = "The impact of exposure to antidepressant medications during pregnancy on neonatal outcomes: a review of retrospective database cohort studies",
abstract = "Introduction: Concerns with prescription antidepressant use in pregnant women have instigated the examination of potential associations between fetal exposure to antidepressant medication and outcomes including preterm delivery, congenital malformations, perinatal and post-natal adverse events, persistent pulmonary hypertension, and mortality. The retrospective cohort model is an often utilized study design. The objective of this review is to evaluate the literature on antidepressant use in pregnancy conducted as retrospective cohorts in national/regional medical, or claims databases that assess neonatal and infant outcomes for agreement between studies, ultimately providing a methodological and outcomes summary for future scientific endeavors. Methods: PubMed was searched for literature relating to antidepressant use and infant outcomes from the earliest available date through July 15, 2016. Studies with a retrospective cohort design and conducted in national/regional medical or claims databases were included. Searched outcomes included preterm delivery, congenital malformations, low birth weight, small for gestational age, persistent pulmonary hypertension of the newborn, and other select adverse events comprising low Apgar score (5 min), convulsions/seizures, respiratory distress/problems, fetal mortality, and infant mortality. Results: Of the 784 studies identified, 36 retrospective cohort studies met eligibility criteria. An increase in preterm delivery and respiratory distress/problems and no increase in congenital malformation or fetal and infant death were associated with prenatal use of prescription antidepressants by majority consensus (at least 2/3 [67{\%}] of studies). Conclusions: While consensus indicates that perinatal prescription antidepressant use has consequences for the fetus and infant, there are notable inconsistencies in the literature. More investigations that address prenatal exposure to depression and other important covariates are needed.",
keywords = "Antidepressants, Database, Maternal-fetal pharmacology, Neonatal outcomes, Pregnancy, Retrospective cohort study",
author = "Tak, {Casey R.} and Job, {Kathleen M.} and Katie Schoen-Gentry and Campbell, {Sarah C.} and Patrick Carroll and Maged Costantine and Diana Brixner and Birnbaum, {Angela K.} and Sherwin, {Catherine M.T.}",
year = "2017",
month = "6",
day = "9",
doi = "10.1007/s00228-017-2269-4",
language = "English (US)",
pages = "1--15",
journal = "European Journal of Clinical Pharmacology",
issn = "0031-6970",
publisher = "Springer Verlag",

}

TY - JOUR

T1 - The impact of exposure to antidepressant medications during pregnancy on neonatal outcomes

T2 - a review of retrospective database cohort studies

AU - Tak, Casey R.

AU - Job, Kathleen M.

AU - Schoen-Gentry, Katie

AU - Campbell, Sarah C.

AU - Carroll, Patrick

AU - Costantine, Maged

AU - Brixner, Diana

AU - Birnbaum, Angela K.

AU - Sherwin, Catherine M.T.

PY - 2017/6/9

Y1 - 2017/6/9

N2 - Introduction: Concerns with prescription antidepressant use in pregnant women have instigated the examination of potential associations between fetal exposure to antidepressant medication and outcomes including preterm delivery, congenital malformations, perinatal and post-natal adverse events, persistent pulmonary hypertension, and mortality. The retrospective cohort model is an often utilized study design. The objective of this review is to evaluate the literature on antidepressant use in pregnancy conducted as retrospective cohorts in national/regional medical, or claims databases that assess neonatal and infant outcomes for agreement between studies, ultimately providing a methodological and outcomes summary for future scientific endeavors. Methods: PubMed was searched for literature relating to antidepressant use and infant outcomes from the earliest available date through July 15, 2016. Studies with a retrospective cohort design and conducted in national/regional medical or claims databases were included. Searched outcomes included preterm delivery, congenital malformations, low birth weight, small for gestational age, persistent pulmonary hypertension of the newborn, and other select adverse events comprising low Apgar score (5 min), convulsions/seizures, respiratory distress/problems, fetal mortality, and infant mortality. Results: Of the 784 studies identified, 36 retrospective cohort studies met eligibility criteria. An increase in preterm delivery and respiratory distress/problems and no increase in congenital malformation or fetal and infant death were associated with prenatal use of prescription antidepressants by majority consensus (at least 2/3 [67%] of studies). Conclusions: While consensus indicates that perinatal prescription antidepressant use has consequences for the fetus and infant, there are notable inconsistencies in the literature. More investigations that address prenatal exposure to depression and other important covariates are needed.

AB - Introduction: Concerns with prescription antidepressant use in pregnant women have instigated the examination of potential associations between fetal exposure to antidepressant medication and outcomes including preterm delivery, congenital malformations, perinatal and post-natal adverse events, persistent pulmonary hypertension, and mortality. The retrospective cohort model is an often utilized study design. The objective of this review is to evaluate the literature on antidepressant use in pregnancy conducted as retrospective cohorts in national/regional medical, or claims databases that assess neonatal and infant outcomes for agreement between studies, ultimately providing a methodological and outcomes summary for future scientific endeavors. Methods: PubMed was searched for literature relating to antidepressant use and infant outcomes from the earliest available date through July 15, 2016. Studies with a retrospective cohort design and conducted in national/regional medical or claims databases were included. Searched outcomes included preterm delivery, congenital malformations, low birth weight, small for gestational age, persistent pulmonary hypertension of the newborn, and other select adverse events comprising low Apgar score (5 min), convulsions/seizures, respiratory distress/problems, fetal mortality, and infant mortality. Results: Of the 784 studies identified, 36 retrospective cohort studies met eligibility criteria. An increase in preterm delivery and respiratory distress/problems and no increase in congenital malformation or fetal and infant death were associated with prenatal use of prescription antidepressants by majority consensus (at least 2/3 [67%] of studies). Conclusions: While consensus indicates that perinatal prescription antidepressant use has consequences for the fetus and infant, there are notable inconsistencies in the literature. More investigations that address prenatal exposure to depression and other important covariates are needed.

KW - Antidepressants

KW - Database

KW - Maternal-fetal pharmacology

KW - Neonatal outcomes

KW - Pregnancy

KW - Retrospective cohort study

UR - http://www.scopus.com/inward/record.url?scp=85020673535&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85020673535&partnerID=8YFLogxK

U2 - 10.1007/s00228-017-2269-4

DO - 10.1007/s00228-017-2269-4

M3 - Article

SP - 1

EP - 15

JO - European Journal of Clinical Pharmacology

JF - European Journal of Clinical Pharmacology

SN - 0031-6970

ER -